![]() ![]() ![]() This predisposes them to atrial fibrillation. Most patients with moderate to severe mitral stenosis will have some degree left atrial enlargement (LAE) due to the chronic increased LA pressures. Symptoms of heart failure with concomitant mitral stenosis also occur in disease states that require an increased cardiac output for the same reason such as pregnancy, anemia, sepsis and thyrotoxicosis. Signs of left heart failure such as paroxysmal nocturnal dyspnea and orthopnea can occur. Fatigue and inability to exercise are also common complaints. This transmission of pressures results in exertional dyspnea. This occurs since the mitral valve area is fixed and the cardiac output is unable to increase enough above resting (a low cardiac reserve is present), and high pressures are transmitted to the pulmonary vasculature since left atrial pressures increase exponentially on exertion. The first symptoms of MS occur on exertion as explained above. I've never knew a cat allergy- I used to pat many and never got breathing difficulties as a result of a touch with them and lately it happends every time.Mitral stenosis is often asymptomatic early in disease until the mitral valve area decreases enough to cause a large increase in left atrial pressure. Lately I get serious attacks after being in a house with a cat. Is there a known connection between asthma and cat allergy? I've been with asthma for many years now but usually get several attacks every year and they are caused from being around pine trees or when I'm with a cold- it also affects my breathing. Preventing asthma attacks is achieved through better control of the disease (with drugs such as inhaled steroids) and through avoidance of triggers such as infections of the lung (vaccinations etc.), avoidance of chemical irritants, pet allergens, cold, dry air etc.Īnd if you have any questions, you may want to consult your doctor. ![]() More advanced treatments is usually given by medical professional as deemed needed. Prompt treatment of asthma attacks is very important and achieved mainly with bronchodilators (medications taken through inhalation), mainly short-acting beta agonists. If the patient feels breathless, than it's no longer preventing the attack but rather treating it. Results of arterial blood gas analyses should be monitored and the patient observed for fatigability when engaged in various levels of activity.Ī. Special observations and methods of assessment of a patient who has dyspnea include: auscultation of the chest for abnormal breath and voice sounds, lung aeration, rales, and rhonchi inspection of the chest for respiratory rate and rhythm and for symmetrical expansion inspection of the skin, lips, and nail beds for cyanosis and percussion of the chest for abnormal resonance. If they already know how to do pursed-lip breathing (inhaling slowly through the nose and exhaling slowly through pursed lips), they may need to be reminded of it and encouraged to use it to improve breathing. Once dyspneic patients are comfortable and less apprehensive, they may need instruction in prolonged, controlled exhalation. If abdominal distention, ascites, or a massive tumor interferes with chest expansion and produces dyspnea, having the patient lie on one side and supporting the abdomen with pillows may provide some relief. Helping the patient relax muscles not needed for breathing conserves oxygen and promotes rest. High Fowler's position or orthopneic position with the arms resting on pillows on an overbed table will help improve chest expansion. The patient should respond favorably to a calm, reassuring manner and an explanation of what is being done to relieve the shortness of breath. If the patient is suffering from an acute attack of dyspnea and has a history of chronic airflow limitation, certain nursing measures can help relieve anxiety and improve ventilation. If there is airway obstruction, clearing the airway is necessary, or a tracheotomy may be performed. In cases of acute respiratory distress, it may be necessary to intubate the patient, begin oxygen therapy, and obtain laboratory arterial blood gas data. If the patient is acutely short of breath, corrective measures should be instituted promptly. A current and past history are obtained and a physical examination completed as soon as possible. Whatever the cause of dyspnea, the plan of care begins with treating the patient and providing adequate oxygenation.Ī thorough assessment of the patient's condition is necessary in order to ascertain the extent of the problem and the urgency of the need. ![]() The dyspneic patient has some degree of difficulty in meeting the basic physiologic need for adequate levels of oxygen in the blood and the transportation of that oxygen to all cells of the body. ![]()
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