Expiratory dyspnea occurs when bronchospasm occurs. In this case, the patency of the small bronchi is disturbed. Bronchioles constrict, secretion accumulates in them, and the mucous membrane swells.
Types of shortness of breath
Difficulty breathing doctors often refer to as dyspnea. This is a disorder of respiratory function that occurs with a number of diseases. Shortness of breath may be inspiratory. It is characterized by difficulty breathing. This type of dyspnea can occur with heart failure or with damage to the upper respiratory tract. It can appear due to bronchospasm, accumulation of pathological secretions, tumors that compress the airways, mucosal edema.
Slow exhalation, at which a slight whistle can be heard, is a sign that expiratory shortness of breath has begun. It occurs when the mucous membrane swells, secretions accumulate in the bronchioles, or obstructions appear that impair the patency of the small bronchi.
There is also mixed shortness of breath. It is characteristic of acute respiratory failure.
You need to understand that shortness of breath -inspiratory and expiratory - caused by different reasons. Therefore, approaches to the treatment of these conditions also differ.
Causes of expiratory shortness of breath
People suffering from bronchial asthma or frequent obstructive bronchitis know what symptoms accompany these diseases. One of their main symptoms is the appearance of shortness of breath. It is characterized by a slow exhalation, which is accompanied by a whistle. The chest is practically not involved in breathing. She is constantly in a position characteristic of inhalation.
Espiratory dyspnea is characteristic of diseases such as:
- bronchial asthma;
- bronchiolitis or obstructive bronchitis;
- chronic ephysema of the lungs, characterized by loss of tissue elasticity;
- bronchial tumors;
- COPD;
- pneumosclerosis of the lungs.
It can also appear when a foreign body enters the respiratory tract. But when an obstruction appears in the trachea and larynx, inspiratory dyspnea appears. But with the narrowing of the large bronchus and trachea, both inhalation and exhalation are difficult.
Characteristics
If the lung function is impaired, expiratory shortness of breath may appear. In this case, inhalation is performed normally, and exhalation is difficult. To release air from the lungs, the patient is forced to make efforts. The respiratory muscles begin to work more actively.
Many complain of pain in the chest area. Also candevelop cyanosis of the lips, the skin becomes noticeably pale. People with this type of dyspnea often experience excessive sweating. As the situation aggravates, the skin may acquire a gray tint, weakness is noticeably increasing.
Despite the fact that exhalation is difficult during expiratory shortness of breath, the patient may begin an asthma attack. But dyspnea can be subtle. The intensity of the manifestations of shortness of breath will depend on the reasons for which it appeared, on the stage of the disease, the presence of sputum.
With the development of this type of dyspnea, air can enter the lungs, but due to swelling and spasm of the walls of the bronchi, it does not completely go out. Often the situation is complicated by the accumulation of viscous mucus.
Clinical signs
It is not always possible to understand that the patient has trouble breathing. In order to pay attention in time and notice the onset of an attack before the onset of complications, you need to know the signs of expiratory shortness of breath.
One of the main things to pay attention to is the length of the exit. It is noticeably increasing. In some cases, its duration may exceed the length of the breath by 2 times. Exhalation is accompanied by significant muscle tension. There are also symptoms of changes in intrathoracic pressure. This is evidenced by the bulging and collapse of the intercostal spaces. At the same time, as you exhale, the neck veins become visible.
Expiratory dyspnea is characteristic of bronchial asthma. With a long course of this disease, you can notice a characteristic box sound, which occurs due to excessive accumulation of air. Because it restricts movement.diaphragm. When tapping certain areas of the chest, you can notice that the borders of the lungs are lowered.
But there are other signs of expiratory shortness of breath that people without a medical background may notice. When you exhale, you can hear a slight whistle or a characteristic crackling sound (crepitus). In some cases, it can even be heard from a distance.
Symptoms of diseases
Given that expiratory shortness of breath is a sign of the development of some of the diseases of the respiratory tract, one must understand how the disease should be determined.
For example, if a patient has obstructive bronchitis, then its characteristic feature is not only the development of respiratory failure, but an increase in temperature. In addition, the patient has increased weakness, pallor of the skin, acrocyanosis. The bluish color of the skin appears on parts of the body remote from the heart: fingers and toes, auricles, lips, nose tip.
But often such a symptom is a sign that asthma has begun. Expiratory dyspnea occurs with an exacerbation of this disease. In most cases, it begins upon contact with the allergen. The disease is seasonal. But deterioration can occur when inhaling tobacco smoke or other substances with a strong odor. Sometimes exacerbation of asthma is associated with increased physical activity. Often attacks begin in the morning or evening hours.
Diagnosis of problems
In somecases, it is necessary to conduct special examinations to understand the nature of the dyspnea that has appeared. Especially dangerous is its occurrence in childhood. In children, expiratory dyspnea is often observed with obstructive bronchitis. In this case, you need to seek help from the hospital. In a medical institution, they can not only accurately establish the diagnosis, but also provide the necessary qualified assistance.
You can find out the nature of shortness of breath with the help of X-ray, ECG, ECHOCG. It also shows a study of the gas composition of the blood. The degree of bronchial obstruction can be determined by measuring the vital volume of the lungs or doing pneumotachometry.
First aid
If you or a person in your environment suffers from asthma attacks, then you need to know what can be done before the doctors arrive. First of all, such a patient must be seated and try to calm him down. Stress leads to an increase in the intensity of heart contractions and an increase in the consumption of oxygen and a number of nutrients. Because of this, expiratory dyspnea may begin to develop more strongly.
The room in which the patient with an attack of dyspnea is located should be well ventilated. In addition, attention should be paid to air humidity. If it is excessively dry, it is advisable to put a pot or kettle of water on the fire and open the lid. You can also hang wet towels or sheets.
Necessary treatment
If a spasm is the cause of shortness of breath, bronchodilators may help. Atpeople suffering from asthma should always have inhalers on hand. Such patients during attacks should use leukothyrene receptor antagonists, monoclonal antibodies, cromones. If the patient is not prescribed appropriate therapy, then over time he may become less sensitive to bronchial dilators (substances that relax smooth muscles and help increase their lumen). Because of this, the patient may experience uncontrolled bouts of shortness of breath.
To relieve spasm, drugs such as Salbutamol, Berotek, Ventolin, Metaprel, Fenoterol, Berodual, Terbutaline can be used. But each of these medicines has side effects and contraindications. Therefore, the selection of the right drug must be carried out together with the doctor.
With obstructive bronchitis, inhalations are also prescribed, because this disease is characterized by expiratory dyspnea. The plan of nursing interventions in this case is to provide bed rest to the patient, limit physical activity and organize the treatment process. The nurse must ensure that all doctor's instructions are followed.
Preventive measures
In some cases, with diseases of the respiratory tract, it is possible to prevent the development of an attack. To do this, you must follow the recommendations of doctors. They boil down to what is needed:
- give up smoking and other bad habits, avoid visiting places where there may be tobacco smoke;
- minimizeexposure to possible allergens, including household chemicals;
- carry out hardening, vitamin therapy;
- reconsider the way of life, devote enough time to good nutrition and rest;
- with the development of bronchitis, use expectorants;
- when attaching a bacterial infection, use antibiotics.
Compliance with the recommended preventive measures and the prompt initiation of treatment in the event of an attack helps the patient to control dyspnea. It is also important to remember that expiratory dyspnea occurs in diseases of the respiratory tract due to narrowing of the small bronchi. Symptomatic therapy should be aimed at relaxing the smooth muscles.
