Pathogenesis (development of disease) Hyperventilation is characterized by an increase in respiration beyond what is required. This results in a decrease in the partial pressure of carbon dioxide in the blood (hypocapnia). At the same time, pH increases, resulting in respiratory alkalosis. Etiology (causes) Behavioral causes Psycho-social situation Aggression Fear Excitement Panic Stress Causes related … Hyperventilation: Causes
In somatic hyperventilation, the underlying disorder must be identified and treated. In psychogenic hyperventilation, the following measures are recommended: General measures Calming the patient, including anxiolysis if necessary, i.e., reducing anxiety with medication. Education If necessary, rebreathing into a bag to enrich the breath with carbon dioxide. Avoidance of psychosocial situations: Aggression Fear Excitement Panic … Hyperventilation: Therapy
To prevent hyperventilation, attention must be paid to reducing individual risk factors. Behavioral risk factors Psychosocial situation Aggression Fear Excitement Panic Stress Environmental stress – intoxications (poisoning). Salicylate intoxication – poisoning with the salt of salicylic acid (acetylsalicylic acid).
The following symptoms and complaints may indicate hyperventilation: Leading symptoms Tachypnea (increased respiratory rate). Irregular breathing Dyspnea (shortness of breath) Functional heart complaints Vertigo (dizziness) Fatigue Concentration problems Visual disturbances Feeling of anxiety Nervousness Insomnia (sleep disorders) Muscle cramps Paresthesias (false sensations) Paw position of the hands Sweating Cold hands Aerophagy (swallowing air) → meteorism, … Hyperventilation: Symptoms, Complaints, Signs
Medical history (history of illness) represents an important component in the diagnosis of hyperventilation. Family history Social history What is your occupation? Is there any evidence of psychosocial stress or strain due to your family situation? Current medical history/systemic history (somatic and psychological complaints). What symptoms have you noticed? How long have these symptoms been … Hyperventilation: Medical History
Respiratory System (J00-J99) Bronchial asthma Endocrine, nutritional and metabolic diseases (E00-E90). Hypocalcemic tetany – neuromuscular hyperexcitability due to a deficiency of calcium → tetanic seizures (with anxious restlessness, hypesthesia (numbness), paresthesias (insensations), and muscle spasms). Cardiovascular system (I00-I99). Coronary artery disease (CAD) – disease of the coronary arteries. Psyche – nervous system (F00-F99; G00-G99). Psychogenic … Hyperventilation: Or something else? Differential Diagnosis
The following are the most important diseases or complications that may be contributed to by hyperventilation: Endocrine, nutritional, and metabolic diseases (E00-E90). Respiratory alkalosis – disturbance of the acid-base balance, which leads to an increase in blood pH above 7.43 (alkalosis) due to respiration (respiratory). Cardiovascular system (I00-I99). Brief fainting
A comprehensive clinical examination is the basis for selecting further diagnostic steps General physical examination – including blood pressure, pulse, body weight,height; furthermore: Inspection (viewing)of the skin and mucous membranes. Auscultation(listening) of the heart [due todifferential diagnosis: coronary heart disease (CHD)]. Auscultation of the lungs [due todifferential diagnosis: bronchial asthma] The following signs may indicate … Hyperventilation: Examination
1st order laboratory parameters – obligatory laboratory tests. Blood gas analysis
Therapy goals Normal respiratory rate (12-18/min). Anxiolysis (drug therapy to reduce anxiety). Therapy recommendations If necessary, rebreathing into a bag to enrich the breathing air with carbon dioxide For anxiolysis: oxazepam, lorazepam (benzodiazepines). Wg. drug therapy of tetany (painful muscle spasms) see under tetany / drug therapy. See also under “Further therapy”.
Optional medical device diagnostics – depending on the results of the history, physical examination, laboratory diagnostics, and obligatory medical device diagnostics – for differential diagnostic clarification. X-ray of the thorax (X-ray thorax/chest), in two planes – if pulmonary disease is suspected. Abdominal ultrasonography (ultrasound examination of abdominal organs) – when diseases of the liver are … Hyperventilation: Diagnostic Tests
