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    Breathing Trouble Not Always Consistent with Medical Tests

    Results of medical tests may not jive with how some asthmatics feel they are breathing. And this may be an important reason for at least some cases of fatal asthma, according to research discussed at the 96th International Conference of the America Thoracic Society in Toronto.

    Richard M. Schwartzstein, MD from Beth Israel Deaconess Hospital in Boston explained, "People don't always perceive or even sense that something is going on with their lungs." In fact, one study revealed that in 60 percent of the patients studied, there was no significant correlation between forced expiratory volume (a commonly used measurement of lung function) and the patients' own assessment of their asthma.

    For patients with respiratory disease, shortness of breath or feeling as though they have to work hard to breathe, are typical indicators of an asthma flare-up. Known as dyspnea, this is frequently the reason patients seek medical attention. But all dyspnea is not created equal, according to Dr. Schwartzstein. And physicians need to be more specific when asking patients to describe how they're feeling.

    Dr. Schwartzstein believes that asking a patient to describe what their dyspnea feels like may provide important clues regarding the underlying cause. Patients often use the following words and phrases to describe their dyspnea:
    Having a feeling of air hunger or the urge to breathe.
    Having to work hard to breathe.
    Feeling unsatisfied by their breathing.
    Chest tightness.
    Shortness of breath or breathlessness.
    Feeling like they're drowning or being smothered.

    Dr. Schwartzstein said that all of these things can be very helpful when trying to determine the exact cause of a patient's dyspnea, particularly when objective measures such as spirometry might not show any significant airway obstruction. Dr. Schwartzstein explained that when objective measures of lung function don't match up with the patient's perceptions, problems could occur on several fronts.

    First, when patients feel they're having trouble breathing even though tests such as spirometry appear to be within a normal range, it can be frustrating for them and misleading to physicians. And because different mechanisms can be at work at the same time in an individual with asthma, that patient may experience dyspnea differently depending on the specific cause at that time.

    What causes a person to have dyspnea?
    Decreased oxygen in the blood and body organs;
    Narrowing airways, which make it more difficult to move air in and out;
    Over-inflation of the lungs;
    Or, stimulation of nerve endings in the lungs and airways.

    It may be that in some patients, dyspnea is caused by stimulation of the nerve endings in the lungs or airways occurring before other things such as airway narrowing are noticeable.

    Perhaps even more concerning are those patients who feel fine but who really aren't. Since dyspnea is usually what motivates patients with asthma to seek medical care, the absence of it in the face of worsening asthma may prevent patients from getting help, sometimes even resulting in death.

    Discussing a number of studies that have addressed this issue, Dr. Schwartzstein explained that several factors might be involved in this phenomenon. The rate at which lung function declines during a given asthma attack may determine the amount of dyspnea a patient feels. For example, during an asthma attack that is progressing quickly, a patient may be more likely to feel dyspnea. Also, patients who have previously had a near-fatal asthma attack may be less alarmed by lower levels of dyspnea because of that experience.

    Dr. Schwartzstein believes that it's also possible that certain medications like bronchodilators may make the patient feel better even when they still have airway obstruction. This is particularly worrisome because those patients may be less likely to comply with treatment even though they need it. Other patients report feeling like their chest tightness has been relieved, but they still have to work hard to breathe.

    Another study of patients using beclamethasone suggested that people who used steroids regularly felt a greater intensity of breathlessness with a 20 percent drop in forced expiratory volume than patients who weren't using steroids regularly. Thus, steroids may help patients sense problems earlier.

    The bottom line? Medical tests as well as a patient's symptoms are both important information for your physician. Be sure to tell your physician when you're having dyspnea and try to be as descriptive as possible when explaining what that dyspnea feels like. is not a comercial or official site. all opinions provided at drugsboat are personal opinions and should not be taken too seriously, but considered. drugsboat holds no responsibility for any negative consequences of it's contents. information is here free for taking, it's visitor's responsibility to use it in a proper way.