Sotalol during pregnancy and lactation
- To date, there is insufficient experience with the use of sotalol during pregnancy and lactation. The decision on the use of sotalol is made by physicians together with their patients.
- Because sotalol crosses the placenta well, it is also suitable for the treatment of arrhythmias with accelerated heartbeat (tachycardia) in the unborn child.
- How to obtain medication with sotalol
- Causes: severe mental tension, depressive states, brain inflammation or tumors, stroke, craniocerebral trauma, poisoning, infections, severe diarrhea, metabolic derailment.
- When to see a doctor? In general, the cause should be clarified, especially in the case of chronic hyperventilation.
- Diagnosis: discussion between doctor and patient, further examinations such as physical examination (e.g., listening to the lungs) or blood sampling.
What is hyperventilation?
The lungs are responsible for the vital gas exchange of the blood. It supplies the blood with fresh oxygen and exhales the carbon dioxide (CO2) produced by cellular respiration.
When hyperventilating, breathing speeds up and at the same time the breaths deepen. Since the blood is already almost 100 percent saturated with oxygen during normal breathing, hyperventilation does not supply the body with any additional oxygen.
Under normal circumstances, the CO2 formed dissolves in the blood and is present there bound as carbonic acid. As the name suggests, this has an acidifying effect on the pH value in the blood. Consequently, when the CO2 and thus the carbonic acid content decreases, an alkalinization of the blood occurs: the pH of the blood increases (it should actually be around 7.4). This resulting condition is called “respiratory alkalosis” by doctors.
Hyperventilation has nothing to do with the normal acceleration of breathing during physical exertion.
How does hyperventilation manifest itself?
The main characteristic of hyperventilation is rapid and deepened breathing. If hyperventilation occurs acutely, it is often accompanied by other symptoms:
- Dizziness
- tingling in fingertips, feet and mouth area
- Palpitations
- trembling
- Visual disturbances
- Shortness of breath
- Tightness in the chest
- Sudden irritating cough
Hyperventilation tetany is manifested by muscle spasms:
- in the hand (“paw position”)
- around the mouth (“carp mouth”)
Chronic hyperventilation sometimes leads to other symptoms. These include:
- Air swallowing with subsequent flatulence
- Frequent urination
- Heart problems and tendency to cramp due to absolute calcium deficiency
- Severe headaches, fatigue and/or difficulty concentrating
Effects of hyperventilation on cerebral blood flow.
The human body is equipped with a number of protective functions and reflex mechanisms. However, under certain circumstances, such a reflex mechanism is also detrimental. This is the case, for example, in hyperventilation with regard to cerebral blood flow:
When the CO2 concentration is high, the brain concludes that the oxygen content is low. It therefore causes the blood vessels in the brain to dilate. This improves the blood supply to the brain and thus provides it with more oxygen.
This mechanism makes sense in itself, because it ensures an adequate supply of oxygen to the brain even when there is less oxygen dissolved in the blood.
What can be done about it?
What helps with hyperventilation depends primarily on the cause.
What can you do yourself?
In the case of hyperventilation caused by psychological factors, such as stage fright or other stressful situations, there are a few first aid measures that are sometimes sufficient to return breathing to normal.
Breathe into the stomach
People who hyperventilate more frequently in certain situations sometimes use this breathing exercise early on to avoid hyperventilating.
Breathe into a bag
However, if hyperventilation has already occurred and tetany with muscle cramps or a tingling sensation has possibly set in, a simple plastic or paper bag can help in many cases. If the person affected exhales and inhales into the bag for a while, carbon dioxide accumulates in the blood.
Ideally, use a paper bag. A plastic bag that is too tightly sealed will in some cases cause the oxygen level in the blood to drop. If only a plastic bag is available, it is important to provide fresh air regularly.
What does the doctor do?
There are no specific medications for medical treatment of hyperventilation, as it is always based on the cause of the hyperventilation.
In the case of psychogenic hyperventilation, doctors first try to reassure the patient. They explain to the sufferer that the current problem does not usually result in any permanent physical consequences. When breathing returns to normal, the symptoms of hyperventilation quickly disappear.
Further measures
Sometimes psychosomatic therapy with a psychologist is useful. This helps to better understand the interactions between body and soul. Psychological triggers for hyperventilation can thus be identified in many cases and alternative strategies for such situations can be developed.
What causes hyperventilation?
Psychogenic causes
Common triggers of psychogenic hyperventilation include:
- Strong tension and/or anger
- Nervousness, excitement
- Anxiety or panic attacks
- Depressive states
Physical causes
Disorders at the physical level that sometimes trigger hyperventilation are:
- Brain inflammation (encephalitis): Among many other symptoms such as fever, headache, paralysis, visual disturbances, etc., it sometimes triggers hyperventilation (due to a disturbance in the respiratory center).
- Stroke: In some cases, hyperventilation is the result.
- Craniocerebral trauma: Hyperventilation also occurs in some cases.
- Poisonings
- Severe infections or blood poisoning (sepsis)
- Extreme diarrhea
- Severe metabolic imbalances such as derailed diabetes mellitus or metabolic syndrome
People who go to high altitudes without sufficient time to adjust may also begin to hyperventilate.
When to see a doctor?
If the cause of hyperventilation is not known or if physical causes are a possible trigger, a visit to the doctor is recommended. Only the doctor is able to determine the causes. In some cases, illnesses such as asthma or heart disease are behind the problem. The first point of contact here is always the family doctor.
The same applies to psychogenic hyperventilation, especially if it occurs more frequently. In this case, the symptoms often disappear quickly as soon as the person concerned calms down a bit and starts breathing normally again. Nevertheless, a visit to the doctor is advisable here as well, since hyperventilation can severely affect sufferers. It is also important to clarify the exact triggers.
How does the doctor diagnose hyperventilation?
If necessary, further examinations are performed, such as a physical examination with listening to the lungs (auscultation) or a blood test. The latter provides information, for example, about the pH value and the concentration of oxygen and carbon monoxide as well as free calcium in the blood.
