Orthopnoea
Encyclopedia
Orthopnea or orthopnoea (Greek
from ortho, straight + pnoia, breath) is shortness of breath (dyspnea
) which occurs when lying flat, causing the person to have to sleep propped up in bed or sitting in a chair. It is the opposite of platypnea
.
From Harrison's Principles of Internal Medicine, 17th ed., page 1446: "Orthopnea is usually a later manifestation of heart failure (HF) than is exertional dyspnea. It results from the redistribution of fluid from the splanchnic circulation and lower extremities into the central circulation during recumbency, with a resultant increase in pulmonary capillary pressure. Nocturnal cough is a frequent manifestation of this process and a frequently overlooked symptom of HF. Orthopnea is generally relieved by sitting upright or by sleeping with additional pillows. Although orthopnea is a relatively specific symptom of HF, it may occur in patients with abdominal obesity or ascites and in patients with pulmonary disease whose lung mechanics favor an upright posture."
It is commonly measured according to the number of pillows needed to prop the patient up to enable breathing (Example: "3 pillow orthopnea").
while recumbent, but usually can be attributed to a more fundamental cause.
Orthopnea is often a symptom
of left ventricular
heart failure and/or pulmonary edema
. It can also occur in those with asthma
and chronic bronchitis
, as well as those with sleep apnea
or panic disorder
. It is also associated with polycystic liver disease
.
Greek language
Greek is an independent branch of the Indo-European family of languages. Native to the southern Balkans, it has the longest documented history of any Indo-European language, spanning 34 centuries of written records. Its writing system has been the Greek alphabet for the majority of its history;...
from ortho, straight + pnoia, breath) is shortness of breath (dyspnea
Dyspnea
Dyspnea , shortness of breath , or air hunger, is the subjective symptom of breathlessness.It is a normal symptom of heavy exertion but becomes pathological if it occurs in unexpected situations...
) which occurs when lying flat, causing the person to have to sleep propped up in bed or sitting in a chair. It is the opposite of platypnea
Platypnea
In medicine, platypnea refers to shortness of breath that is relieved when lying down, and worsens when sitting or standing up. It is the opposite of orthopnea...
.
From Harrison's Principles of Internal Medicine, 17th ed., page 1446: "Orthopnea is usually a later manifestation of heart failure (HF) than is exertional dyspnea. It results from the redistribution of fluid from the splanchnic circulation and lower extremities into the central circulation during recumbency, with a resultant increase in pulmonary capillary pressure. Nocturnal cough is a frequent manifestation of this process and a frequently overlooked symptom of HF. Orthopnea is generally relieved by sitting upright or by sleeping with additional pillows. Although orthopnea is a relatively specific symptom of HF, it may occur in patients with abdominal obesity or ascites and in patients with pulmonary disease whose lung mechanics favor an upright posture."
It is commonly measured according to the number of pillows needed to prop the patient up to enable breathing (Example: "3 pillow orthopnea").
Causes
Orthopnea is due to increased distribution of blood to the pulmonary circulationPulmonary circulation
Pulmonary circulation is the half portion of the cardiovascular system which carries Oxygen-depleted Blood away from the heart, to the Lungs, and returns oxygenated blood back to the heart. Encyclopedic description and discovery of the pulmonary circulation is widely attributed to Doctor Ibn...
while recumbent, but usually can be attributed to a more fundamental cause.
Orthopnea is often a symptom
Symptom
A symptom is a departure from normal function or feeling which is noticed by a patient, indicating the presence of disease or abnormality...
of left ventricular
Left ventricle
The left ventricle is one of four chambers in the human heart. It receives oxygenated blood from the left atrium via the mitral valve, and pumps it into the aorta via the aortic valve.-Shape:...
heart failure and/or pulmonary edema
Pulmonary edema
Pulmonary edema , or oedema , is fluid accumulation in the air spaces and parenchyma of the lungs. It leads to impaired gas exchange and may cause respiratory failure...
. It can also occur in those with asthma
Asthma
Asthma is the common chronic inflammatory disease of the airways characterized by variable and recurring symptoms, reversible airflow obstruction, and bronchospasm. Symptoms include wheezing, coughing, chest tightness, and shortness of breath...
and chronic bronchitis
Bronchitis
Acute bronchitis is an inflammation of the large bronchi in the lungs that is usually caused by viruses or bacteria and may last several days or weeks. Characteristic symptoms include cough, sputum production, and shortness of breath and wheezing related to the obstruction of the inflamed airways...
, as well as those with sleep apnea
Sleep apnea
Sleep apnea is a sleep disorder characterized by abnormal pauses in breathing or instances of abnormally low breathing, during sleep. Each pause in breathing, called an apnea, can last from a few seconds to minutes, and may occur 5 to 30 times or more an hour. Similarly, each abnormally low...
or panic disorder
Panic disorder
Panic disorder is an anxiety disorder characterized by recurring severe panic attacks. It may also include significant behavioral change lasting at least a month and of ongoing worry about the implications or concern about having other attacks. The latter are called anticipatory attacks...
. It is also associated with polycystic liver disease
Polycystic liver disease
Polycystic liver disease usually describes the presence of multiple cysts scattered throughout normal liver tissue, in association with polycystic kidney disease.-Pathophysiology:Associations with PRKCSH and SEC63 have been described....
.