Physiologic changes and clinical correlates of advanced dyspnea

Area of Science:

• Respiratory Medicine
• Pathophysiology
• Symptom Science

Background:

• Dyspnea is a prevalent and complex symptom in patients with chronic respiratory illness and end-stage disease.
• The subjective experience of dyspnea often involves significant discomfort, fear, and anxiety.

Purpose of the Study:

• To review the pathophysiology of dyspnea in patients with chronic respiratory illness or end-stage disease.
• To incorporate recent advancements in understanding this complex symptom.

Main Methods:

• Literature review of recent publications on dyspnea pathophysiology.
• Analysis of new conceptual models and research findings in pulmonary rehabilitation and exercise testing.

Main Results:

• A new multidimensional model of dyspnea, analogous to pain models, offers novel insights into its pathophysiology.
• Research in pulmonary rehabilitation, exercise testing, and distractive auditory stimulation has advanced understanding.
• New data illuminate the emotional responses associated with laboratory-induced dyspnea.

Conclusions:

• Dyspnea is a multifaceted symptom with diverse causes and pathophysiologies, common in advanced disease.
• The subjective nature of dyspnea contributes to patient distress, including fear and anxiety.
• Routine evaluation of dyspnea alongside vital signs is recommended for comprehensive patient assessment.