Before moving on to what shortness of breath is, its relationship with the heart and other causes, we need to ask "what is breathing really?" Let's answer the question.
Oxygen is a vital molecule found in the air and required for all our vital activities. It is indispensable for the body's energy metabolism. For example, while our brain can only withstand a lack of oxygen for 3-5 minutes, the heart muscles suffer irreversible damage (infarction) within hours when they are left without oxygen.
Breathing actually means taking oxygen from the air. This work is achieved by working in harmony with a very complex chain of mechanisms in which the brain, nerves, hormones, diaphragm muscle, respiratory muscles in the chest wall, upper and lower respiratory tracts, lungs and lung membranes play a role. After oxygen is taken into the lungs, it passes through very thin permeable membranes and enters the blood vessels, where it is delivered to the heart via red blood cells (red blood cells) and from there to the whole body. This part of the event is called "circulation", but if we look at it from the perspective of oxygen's travel; Respiration and circulation are two mechanisms that are dependent on each other and continue each other.
Disruptions at any point in breathing and circulation may appear as disorders, diseases, shortness of breath and premature fatigue.
(Although "shortness of breath" and "early fatigue-fatigue" are often seen together, they are separate conditions in terms of cause, effect and approach. Since this distinction is rather an academic issue, I prefer not to mention it here.)
After these preliminary explanations, “What is Shortness of Breath?” We can move on to the question.
Breathing is a spontaneous event that is rhythmically adjusted by our respiratory center in our brain, and which we are not particularly aware of unless we direct our attention to it. Shortness of breath (dyspnea) is a state in which breathing requires special effort and is difficult, tiring and difficult to be aware of. If we look at it causally, we can also define it as "oxygen starvation".
Heart-Induced Shortness of Breath:
Heart The main mechanism in respiratory distress is very simplified. To put it another way, it is the accumulation of blood that the heart cannot pump and send forward for any reason, towards the lungs or escaping back (= stasis). As you can see below for easier understanding, blood has a journey like this:
Still, it may have been a bit complicated. . Let's simplify it even more.
When this flow encounters an obstacle at any point or events that reverse the flow, a pressure and volume begins in the area just behind the point of the obstacle and moves towards the areas further back over time.
Let's think like this: Let's say there is a village built on the riverside, a dam in the lower parts of the river, and the dam has a gate that always allows a certain amount of water to pass through. Under normal circumstances, there is no problem in the village by the river. However, if the dam gates remain closed all the time and do not allow water passage, the water level in the areas behind the dam will begin to rise, and if this continues for a long time, the village further behind will be flooded.
Let's imagine this village as our lungs and the dam as our heart. If for some reason the dam cannot send the water properly, the village will be flooded. If our heart cannot send the blood forward in any way, our lungs in the back will be flooded, that is, pulmonary edema will occur. This causes shortness of breath as it reduces the capacity of the lungs to fill with air and mix oxygen into the blood.
In situations that increase the heart rate (that is, if we compare it again, if a river that becomes full with the melting of snow in the spring months has the same dam valve problem, the village will be flooded more easily. etc.), shortness of breath becomes more pronounced.
Common causes of heart-related shortness of breath:
Heart Failure: Loss in the pumping power of the heart muscle due to any reason is called “Heart Failure”. Since the heart cannot send blood forward (to the body), blood accumulates backwards towards the lungs, causing shortness of breath. While loss of strength in the heart muscle can be due to many reasons, it most commonly occurs as a result of inadequate nutrition of the heart in coronary vascular diseases and enlargement and loss of elasticity of the heart due to valve diseases.
Valve Diseases:If the valves that need to open in front of the rapidly flowing blood in the heart do not open (most commonly Mitral Valve Stenosis and Aortic Valve Stenosis) or if the valves that need to close to prevent blood from flowing in the opposite direction do not close (most commonly Mitral Valve Insufficiency and Aortic Valve Stenosis). Aortic Valve Insufficiency) causes shortness of breath by increasing blood pressure and volume in the lungs.
Cardiovascular Diseases:In case of excessive fluid accumulation (tamponade) or adhesions between the membranes, the heart Since it cannot expand enough and receive enough blood, heart failure and therefore shortness of breath develop.
Coronary Vascular Diseases:Angina pectoris, which occurs due to narrowing and occlusion of the heart vessels, can sometimes be perceived as shortness of breath. This type of shortness of breath is called "angina equivalent." In addition, pumping insufficiency due to lack of nutrition of the heart muscle is also a cause of shortness of breath.
Heart rhythm disorders and cardiomyopathies are other causes of heart-related shortness of breath.
Heart-related shortness of breath. Shortness of breath may occur only during advanced exercise, depending on the level of the disease, or may occur even at rest in advanced disease. Sudden onset of severe shortness of breath accompanied by a severe dry-chilling cough followed by pink frothy sputum indicates that almost the entire lungs are filled with fluid, and this situation is called "Pulmonary Edema". The expression that best describes pulmonary edema is; It is "a person drowning in his own water".
Shortness of breath that develops while lying down is mostly related to the heart. It is also accompanied by cough. Shortness of breath that develops 2-3 hours after going to bed at night is usually relieved by getting up and sitting up. Attacks can be mild, but they can also be accompanied by wheezing, cough, severe shortness of breath and panic. Sometimes it can lead to pulmonary edema. It develops in people with heart failure due to the increase in central blood volume when they sleep at night. When the blood pooled in the legs is added to the central blood system at night, the heart, which is already working at the limit, goes into failure.
Other Shortness of Breath N Causes:
Lung Diseases: The most common causes of shortness of breath, along with heart diseases. In many cases, it may be difficult to distinguish which causes shortness of breath. Sometimes both are the cause. Lung infections (pneumonia), chronic bronchitis, asthma, pulmonary embolism, pneumothorax, lung cancers, pleural inflammation, sarcoidosis, pulmonary hypertension and tuberculosis may be lung-related causes of shortness of breath.
Blood Diseases (often anemia), Excessive weight (obesity), thyroid hormone disorders, upper respiratory tract obstructive diseases, some neurological diseases (myasthenia, Gullian-Barre Syndrome), anxiety (stress) disorders are also among the causes of shortness of breath.
Common and disease-related causes. We can say that a situation that is thought to be "physical lack of exercise". The 21st century people, who live sedentary lives, park their cars at the closest point to their work and home, and wait in line for the escalator in the subway or shopping mall, lose their strength in their inactive muscles and get tired early and become short of breath after walking two steps. The solution is to walk….
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