Cardiovascular disease

Patients with heart disease frequently present with the sensation of breathlessness in a variety of clinical circumstances, and the mechanism of this is poorly understood.

Acute heart failure may induce left ventricular failure leading to pulmonary dema, which is the probable cause of breathlessness. Ischemic heart disease can trigger transient left ventricular failure.

Different abnormalities may contribute to the sensation of breathlessness in chronic heart failure. Some patients present with bronchial hyper-responsiveness. Decreased lung compliance may contribute to breathlessness but does not seem to be a major determinant. Muscle fatigue, associated with low cardiac output, may also play a role.

Acute unexplained dyspnea may be a clinical sign of pulmonary embolism. Because of mismatching in the ventilation-to-perfusion ratio, even a low degree of obstruction produces hypoxemia which is responsible for the breathlessness. Greater obstruction may provoke pulmonary hypertension or cardiogenic shock, which also cause breathlessness.

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