Use of breathing retraining exercises and SSRIs in patients with hyperventilation syndrome

Hyperventilation syndrome (HVS) is a condition that is seen in almost 10% of the general adult population. It presents with difficulty breathing, often in conjunction with anxiety, dizziness and light-headedness. We report a case involving a woman in her 30s, who presented to the emergency room with a primary complaint of shortness of breath and had a prolonged expiratory phase on examination. During a follow-up office visit, she had a generalised anxiety disorder-7 (GAD-7) score of 11, consistent with moderate anxiety. The diagnosis of HVS was made, and the patient began breathing retraining exercises and a selective serotonin reuptake inhibitor (SSRI), fluoxetine. At her subsequent visit 1 month later, the patient reported significant improvement in both her shortness of breath and anxiety. Her GAD-7 score had decreased to 4, consistent with minimal anxiety. We believe that early recognition, behavioural interventions and SSRIs improved the patient's outcome.