Pathophysiology of Dyspnea
Abstract
Dyspnea may be defined as an uncomfortable sensation of breathing. The sense of respiratory effort, chemoreceptor stimulation, mechanical stimuli arising in lung and chest wall receptors, and neuroventilatory dissociation may all contribute to the sensation of dyspnea. Different mechanisms likely give rise to qualitatively different sensations of dyspnea. In most patients, dyspnea is probably due to a combination of mechanisms. For example, in asthma, a heightened sense of effort, neuroventilatory dissociation, and vagal stimuli arising from bronchoconstriction and airway inflammation may all play a role. Patients with different disorders and different mechanisms of dyspnea use different phrases to describe their breathing discomfort. Hence, the language patients use to describe their dyspnea may provide clues to the etiology of their symptoms.
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Breathlessness perception is driven by a mismatch between demand for ventilation and afferent information on actual ventilation.
“Breathlessness perception is believed to be driven by a mismatch between the two.”
From The Breathing, Thinking, Functioning clinical model: a proposal to facilitate evidence-based breathlessness management in chronic respiratory disease (2017) · cites this paper as [13]
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Self-citation
- Authors
- Manning, H. L., & Schwartzstein, R. M.
- Affiliations
- Dartmouth–Hitchcock Medical Center (US)
- Harvard University (US)
- Venue
- New England Journal of Medicine
- Publisher
- Massachusetts Medical Society
- Published
- 1995-12-07
- Volume
- 333
- Issue
- 23
- Pages
- 1547-1553
- ISSN
- 0028-4793 (ISSN-L)
- 1533-4406
- OpenAlex
- W2314290171
- Cited by
- 472
- References
- 49
- Citations by year
- 2026: 7 · 2025: 9 · 2024: 6 · 2023: 10 · 2022: 16 · 2021: 20 · 2020: 24 · 2019: 16 · 2018: 13 · 2017: 16 · 2016: 20 · 2015: 14 · 2014: 18 · 2013: 15 · 2012: 23
- FWCI
- 2.08
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- New England Journal of Medicine (publishedVersion)
- PubMed (publishedVersion)
- Funders
- National Institutes of Health (5p50hl019170-20)
- National Heart, Lung, and Blood Institute (HL 19170)
- Topics
- Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Respiratory and Cough-Related Research
- Life Sciences › Neuroscience › Endocrine and Autonomic Systems › Neuroscience of respiration and sleep
- Health Sciences › Medicine › Physiology › Asthma and respiratory diseases
- Keywords
- dyspnea, pathophysiology, chemoreceptor stimulation, asthma, bronchoconstriction, airway inflammation
- MeSH terms
- Asthma, Dyspnea, Female, Humans, Male, Neuromuscular Diseases, Prognosis, Pulmonary Embolism, Risk Factors, Lung Diseases, Interstitial, Ventricular Dysfunction, Left, Risk Assessment, Pulmonary Disease, Chronic Obstructive
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