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Topic: Orthopnea

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	Orthopnea definition - Medical Dictionary definitions of popular medical terms
		Orthopnea definition - Medical Dictionary definitions of popular medical terms
		Orthopnea: The inability to breathe easily unless one is sitting up straight or standing erect.
		Aortic Stenosis - Learn about aortic valve stenosis, an abnormal narrowing of the aortic valve in the heart.
	www.medterms.com /script/main/art.asp?articlekey=4671 (166 words)

	Respiratory Distress
		Orthopnea - increased respiratory distress when the patient is lying down or the chest is compressed.
		Abnormal sounds (stridor, wheezes), abnormal posture (orthopnea, head and neck extended, elbows abducted, sternal recumbency), abnormal mucous membrane color (cyanosis or pale), tachypnea, weakness and exhaustion, altered respiratory effort (shallow and rapid, or labored and forceful, or absent), and vigorous resistance to restraint are the typical signs present in animals with respiratory distress.
		Disorders such as hyperthermia, shock, metabolic acidosis and alkalosis, hyperthyroidism, fear or anxiety, pericardial tamponade, anemia, abdominal organ enlargement or ascites, and abnormalities with central control of respiration from drugs and metabolic or organic central nervous system disease are all causes of signs that may mimic true respiratory distress.
	www.cvmbs.colostate.edu /clinsci/wing/trauma/dyspnea.htm (3077 words)

	Expiratory flow limitation is associated with orthopnea and reversed by vasodilators and diuretics in left heart ... (Site not responding. Last check: )
		Orthopnea was defined as a positive difference in the Borg score between measurements made with the patient in the supine and seated positions.
		The frequent association of orthopnea and increased pulmonary venous congestion in patients with acute LHF has led many authors to regard posture-related vascular engorgement of the lungs as a key factor in the increase of breathlessness with recumbency.
		The aim of this study was to confirm these findings and to assess whether EFL disappeared, especially with patients in the supine position, as orthopnea improved after short-term treatment with diuretics and vasodilators in patients affected by acute LHF.
	www.findarticles.com /p/articles/mi_m0984/is_2_128/ai_n15379447 (712 words)

	Orthopnea - WrongDiagnosis.com
		Orthopnea: Shortness of breath that is relieved by sitting up.
		The cause of Orthopnea may be more easily identified if other symptoms exist.
		When you follow a link to our interactive multiple symptoms page, you will be able to modify your list by adding and removing symptoms thus helping to better research your condition.
	www.wrongdiagnosis.com /sym/orthopnea.htm (745 words)

	Association of Veterans Affairs Anesthesiologists
		Symptoms of dyspnea at rest, PND, orthopnea or pulmonary edema suggest no reserve and probably chronic low cardiac output with high resting sympathetic tone.
		An increase in cardiac output worsens the pressure drop across the obstruction and as described above, may lead to angina, palpations, dizziness/syncope or dyspnea on exertion.
		With elevated pulmonary pressures, fatigue, PND and orthopnea appear.
	www.vaanes.org /FORUMS/ValvesAVAA.html (7571 words)

	Case (Site not responding. Last check: )
		Following weight, is a good index of control of congestive heart failure and drug regimens are adjusted based on serial follow up of weights.
		When shortness of breath is ameliorated in upright position we call it orthopnea.
		Understanding the mechanism of orthopnea in each instance is important.
	www.meddean.luc.edu /lumen/MedED/mech/cases/case24/answers2.htm (615 words)

	Orthopnea on Find Articles (Site not responding. Last check: )
		Background: In patients with acute left heart failure (LHF), orthopnea has also been related to the occurrence or worsening of expiratory flow limitation...
		Orthopnea and tidal expiratory flow limitation in patients with euthyroid goiter - clinical investigations
		Background: Orthopnea is a common feature in COPD patients, although its nature is poorly understood.
	calbears.findarticles.com /p/search?tb=art&qt=Orthopnea (542 words)

	Evidence based physical diagnosis
		Mohammed Hijazi, MD Clinical Scenario: 44 year old male preseted to the ER with dyspnea and Orthopnea.
		Question: Is Orthopnea specific for left sided heart failure.
		Answer: The occurrence of orthopnea is not specific for left sided heart failure.
	www.kfshrc.edu.sa /medicine/files/Orthopnia.htm (128 words)

	PCCU Volume 19, Lesson 21
		In the upright position, the accessory muscles are able to achieve sufficient minute ventilation in the absence of any diaphragmatic activity, although the diaphragm may be pulled upwards into the thorax to some degree by the negative intrathoracic pressure.
		In contrast to the orthopnea characteristic of congestive heart failure, the orthopnea of diaphragmatic paralysis occurs immediately after the patient is placed in the supine position.
		Interestingly, the presence of orthopnea, and not the degree of dyspnea, correlates with diaphragmatic strength.
	www.chestnet.org /education/online/pccu/vol19/lessons21_22/print21.php (0 words)

	THE MERCK MANUAL OF GERIATRICS, Ch. 47, Sleep Disorders
		In patients with dementia, insomnia with nocturnal agitation may be a symptom of a disorder that causes nocturnal symptoms (eg, pain, orthopnea).
		Other symptoms also worsen at night; examples are dyspnea (eg, due to emphysema), orthopnea (eg, due to heart failure), and symptoms of Parkinson's disease.
		Specialized testing, such as polysomnography done in a sleep laboratory, is usually indicated if sleep apnea, narcolepsy (rare in the elderly), periodic limb movement disorder, or an unusual parasomnia is suspected.
	www.merck.com /mrkshared/mmg/sec6/ch47/ch47b.jsp (2208 words)

	Cardiovascular History Taking Objectives
		Chest pain – AKA angina pectoris, which results from a temporary difference between the supply and the demand of oxygen to the heart muscle. Angina can be the result of low oxygen levels in the blood, restricted blood flow to the heart or an increase in the work of the heart beyond normal levels.
		Orthopnea – dyspnea that occurs when the pt is lying down and improves upon sitting up. Classicly quantified by # of pillows pt uses to sleep on. Suggests Lt ventricular failure, mitral stenosis or obstructive lung disease.
		If either orthopnea or PND have a recent onset or increasing frequency, prompt evaluation is need for the precipitating cause.
	faculty.washington.edu /alexbert/MEDEX/Fall/CV_Hx_Obj.htm (4644 words)

	Medical Dictionary: Orthopnea - WrongDiagnosis.com
		Orthopnea: Breathlessness that prevents a patient from lying down and hence has to sleep sin a sitting up position.
		Orthopnea: form of dyspnea in which the person can breathe comfortably only when standing or sitting erect; associated with asthma and emphysema and angina pectoris
		Orthopnea (symptom): Shortness of breath that is relieved by sitting up.
	www.wrongdiagnosis.com /medical/orthopnea.htm (268 words)

	Clinical Vignettes from CMI: Heart Failure
		Orthopnea suggests continued elevation of pulmonary wedge pressure and the need for further diuresis, vasodilation, or both.
		The 78-year-old woman in the Vignette was based on an actual patient but was altered in one important respect: The actual echocardiogram revealed normal chamber sizes, left ventricular hypertrophy, mildly elevated pulmonary artery systolic pressure (between 45 mm Hg and 50 mm Hg), and normal LVEF ranging from 70% to 75%.
		This patient presented with classic heart failure: orthopnea, weight gain, elevated neck veins, and a characteristic response to diuresis.
	xnet.kp.org /permanentejournal/winter03/heart.html (4173 words)

	WOCKHARDT HOSPITAL-Heart Hospital-Symptoms & Diagnosis
		The pain may increase steadily until it becomes almost unbearable, radiate to shoulder and arms, may produce anxiety and fear resulting in increased heart rate, blood pressure and respiration.
		Exercise intolerance, fatigue, dry cough, anorexia, dysarrhythmia (irregular heart beat), night dyspnea (difficulty in breathing), orthopnea (inability to breath other than upright position,) palpitations (awareness of the ones own heart beat) are also common.
		Left sided failure leads to shortness of breath, dyspnea on exertion, paroxysmal nocturnal dyspnea (dyspnea during night) orthopnea (unable to breath other than upright position) cough, fatigue, restlessness, insomnia, and tachycardia.
	www.wockhardthospitals.com /heart_symptoms.html (1288 words)

	399 Medicine I, Spring 2006 - OpenCourseWare - Tufts University
		Orthopnea is a dyspnea that occurs when the patient is lying down and is relieved when the patient sits up.
		Orthopnea can occur due to obstructive lung disease, mitral stenosis, left ventricular failure or CHF.
		Paroxysmal nocturnal dyspnea involves sudden episodes of dyspnea and orthopnea that wake the patient up from deep sleep.
	ocw.tufts.edu /Content/24/lecturenotes/310648 (1144 words)

	MedlinePlus Medical Encyclopedia: Breathing difficulty - lying down
		What to expect at your health care provider's office
		Waking at night short of breath; Paroxysmal nocturnal dyspnea; PND; Difficulty breathing while lying down; Orthopnea
		Breathing difficulty while lying down is an abnormal condition.
	www.nlm.nih.gov /medlineplus/ency/article/003076.htm (0 words)

	Health Library -
		For example, "three-pillow" orthopnea is worse than "two-pillow" orthopnea because you have less tolerance for lying flat.
		The reason you may have orthopnea is that when you lie flat, the blood that ordinarily pools in the veins of your legs is reentering your bloodstream.
		If you have heart failure, your heart may not be able to keep up with the increased amount of blood returning to the heart, so fluid builds up inside the lungs and causes shortness of breath.
	www.memorialhermann.org /library/healthguide/en-us/support/topic.asp?hwid=tx4082abc (611 words)

	CARDIAC
		ORTHOPNEA: Dyspnea occurring with patient in the supine position.
		Orthopnea is a sign of Congestive Heart Failure that is more severe than that associated with exertional dyspnea.
		Unlike orthopnea, It is not relieved immediately by sitting up.
	www.angelfire.com /journal2/clinica_cayanga/cardiac.htm (3121 words)

	Expiratory Flow Limitation and Orthopnea in Massively Obese Subjects -- Ferretti et al. 119 (5): 1401 -- Chest
		Synoptic panel showing the presence of EFL in subjects in both the seated and supine positions and its relationship with orthopnea in 46 healthy obese subjects.
		Orthopnea, defined as any increase in dyspnea with recumbency (closed symbols), was more frequent and severe in obese subjects who had EFL in the supine position (FL).
		Orthopnea, although mild, was claimed by almost half of the
	www.chestjournal.org /cgi/content/full/119/5/1401 (4697 words)

	[No title] (Site not responding. Last check: )
		She notes a several month history of dyspnea with walking 1 flight of steps and one block especially if walking up a hill.
		She denies associated chest discomfort, cough, wheezing, orthopnea or PND.
		She does note mild bilateral leg edema at the end of the day.
	www.georgetown.edu /departments/medicine/residency/ambulatory/dyspnea2005.DOC (361 words)

	CAT.INIST
		OBIECTIVES To assess the contribution of expiratory flow limitation (FL) in orthopnea during acute left heart failure (LHF).
		In other settings, such as chronic obstructive pulmonary disease, dyspnea correlates best with expiratory FL and can, therefore, be interpreted as, in part, the result of a hyperinflation-related increased load to the inspiratory muscles.
		As airway obstruction is common in acute LHF, postural FL could contribute to orthopnea.
	cat.inist.fr /?aModele=afficheN&cpsidt=1289978 (439 words)

	Evolve: Ackley: Nursing Diagnosis Handbook, 7th Edition - Excess Fluid volume
		EB: A study demonstrated that body weight could safely be used to monitor for fluid overload when administering hyperhydration with high dose chemotherapy (Mank et al, 2003).
		EditMonitor lung sounds for crackles, monitor respirations for effort, and determine the presence and severity of orthopnea.
		EditWith head of bed elevated 30 to 45 degrees, monitor jugular veins for distention in the upright position; assess for positive hepatojugular reflex.
	www1.us.elsevierhealth.com /Evolve/Ackley/NDH7e/Constructor/careplan_031.php (1932 words)

	[No title]
		Be able to define the following terms and state their general significance in cardiovascular disease patterns: Chest pain Murmurs Orthopnea Cyanosis Paroxysmal nocturnal dyspnea Claudication Edema Hypertension Palpitations 2.
		Identify the general anatomic sources of chest pain (organ systems, not individual diseases) that are most commonly responsible for the symptom.
		Identify the specific cardiac disease associated with orthopnea and paroxysmal nocturnal dyspnea.
	faculty.washington.edu /alexbert/MEDEX/Fall/CV_Hx_Obj.doc (381 words)

	Case Rounds: Case 10 (Site not responding. Last check: )
		A 32 year old man with a history of HIV was admitted in June 1998 to Johns Hopkins Hospital with a one week history of progressive dyspnea on exertion, orthopnea, PND, and mild left leg edema.
		He re-presented on 6/2/98 with symptoms of DOE, orthopnea, PND, left leg edema, fever, chills, and a dry cough.
		CXR and echo showed evidence of a large pericardial effusion, and he was admitted to the cardiac SICU for further management.
	www.hopkins-aids.edu /educational/caserounds/caserounds_10.html (760 words)

	Expiratory Flow Limitation and Orthopnea in Massively Obese Subjects -- Ferretti et al. 119 (5): 1401 -- Chest
		Expiratory Flow Limitation and Orthopnea in Massively Obese Subjects -- Ferretti et al.
		Purpose: The aim of the study was to assess EFL and orthopnea
		Orthopnea and tidal expiratory flow limitation in chronic heart failure.
	www.chestjournal.org /cgi/content/abstract/119/5/1401 (768 words)

	1999 ERAS Application Essay (Site not responding. Last check: )
		We had been discussing the differential diagnosis of orthopnea during attending rounds on my third year medicine rotation, and the intern had summarized one portion of the differential by stating that anything which causes an increase in intra-abdominal pressure can result in orthopnea.
		Pressure is, however, a relative property, and so it quickly occurred to me that the real key lay in the balance of pressures between the thoracic and abdominal cavities.
		Decreasing intra-thoracic pressure should therefore induce orthopnea in the same manner as increasing intra-abdominal pressure, and a phrenic nerve paralysis seemed like a plausible candidate for decreasing intra-thoracic pressure.
	www.mailbag.com /users/rapture/eras.html (609 words)

	(Print Version) Congestive Heart Failure And Cardiomyopathy
		This is the case when a patient needs several pillows to sleep on to prevent shortness of breath.
		Another way orthopnea manifests is that the patient may awaken short of breath and go stand up by a window to breathe better.
		The patient may present with edema, shortness of breath, and fatigue and orthopnea as described above.
	www.lef.org /protocols/prtcls-txt/t-prtcl37.html (2346 words)

	CHF & Cardiomyopathy
		In particular, the patient may develop orthopnea or cardiac asthma.
		This is the case when a patient needs several pillows to sleep on to prevent shortness of breath.
		Another way orthopnea manifests is that the patient may awaken short of breath and go stand up by a window to breathe better.
	www.dfwcfids.org /medical/chf.htm (2644 words)

	Case Rounds: Case 10 (Site not responding. Last check: )
		A 32 year old man with a history of HIV was admitted in June 1998 to Johns Hopkins Hospital with a one week history of progressive dyspnea on exertion, orthopnea, PND, and mild left leg edema.
		He re-presented on 6/2/98 with symptoms of DOE, orthopnea, PND, left leg edema, fever, chills, and a dry cough.
		CXR and echo showed evidence of a large pericardial effusion, and he was admitted to the cardiac SICU for further management.
	hopkins-aids.edu /educational/caserounds/caserounds_10.html (760 words)

	- Northwestern Memorial Hospital - Chicago (Site not responding. Last check: )
		Breathing difficulty while lying down is an abnormal condition in which a person must keep the head elevated (such as by sitting or standing) to be able to breathe deeply or comfortably (orthopnea), or the person awakens suddenly during the night feeling short of breath (paroxysmal nocturnal dyspnea).
		Waking at night short of breath; Paroxysmal nocturnal dyspnea; PND; Difficulty breathing while lying down; Orthopnea
		For people with some types of heart or lung problems, this is a common complaint.
	www.nmh.org /nmh/adam/adamencyclopedia/HIEArticles/003076.htm (0 words)

	Untitled
		The goals of therapy are to improve the quality of life, decrease mortality and reduce the compensatory mechanisms causing the symptoms.
		During initial evaluation, the clinician should determine whether the patient manifests symptoms (e.g., orthopnea, paroxysmal nocturnal dyspnea, dyspnea on exertion) or signs (e.g., pulmonary rales, a third heart sound, jugular venous distention) of volume overload.
		The hemodynamic effects of ACE inhibitors in HF include decreased afterload, preload, and mean arterial pressure, and increased cardiac output.
	www.continuingeducation.com /nursing/heart/treatment.html (6590 words)

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