This condition can also show up in your day to day life. If you get badly out of breath, several times over a short period, and find that you remain badly short of breath for the next day or so, it may be a sign of orthopnea. The COPD can cause an issue between the lungs and heart that causes fluid to build up in the chest cavity and can cause hearth failure.
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What is orthopnea?
19 October 2018
By Aaron Kandola
Orthopnea is a shortness of breath that affects a person when they are lying down but subsides in other positions, such as standing or sitting up. Orthopnea is often a symptom of heart failure or lung disease, but it can also result from other conditions.
For people with orthopnea, the breathing difficulty typically disappears quickly after they get up from a horizontal position. In a related condition known as paroxysmal nocturnal dyspnea, the shortness of breath wakes the person up a couple of hours after they fall asleep.
In this article, we look at the symptoms, causes, diagnosis, and treatment of orthopnea.
Symptoms
Orthopnea is shortness of breath that occurs while lying down.
Orthopnea is a symptom rather than a condition in itself. The medical term for shortness of breath is dyspnea. Orthopnea is a type of dyspnea that only occurs when a person is lying down.
People often describe orthopnea as a sensation of tightness in the chest that makes breathing difficult or uncomfortable. Some individuals may also experience chest pain.
Orthopnea can be mild or severe. Some people may barely notice this symptom when they use one or two pillows to prop up their upper body. For others, it can cause significant breathing difficulties that they can only relieve by sitting upright or standing.
Other symptoms can also occur, which will depend on the underlying cause. For example, a common cause of orthopnea is heart failure, which can also cause the following symptoms:
fatigue
changes in appetite
nausea
confusion
increased heart rate
persistent coughing or wheezing
Causes
Orthopnea is often a symptom of conditions that affect the normal functioning of the lungs. These can include heart conditions.
Heart disease may result in the heart being unable to redistribute blood and other bodily fluids effectively while a person is lying down. The increased pressure in the blood vessels in the lungs can push fluid into the alveoli, causing a condition known as pulmonary edema.
The alveoli are small air sacs in the lungs. Here, oxygen passes from the lungs into the bloodstream, while carbon dioxide moves from the blood into the lungs. Fluid in the alveoli can interfere with this gaseous exchange, preventing a person from getting enough oxygen around their body.
Several other conditions can also cause orthopnea, including:
chronic obstructive pulmonary disease (COPD)
obesity
anxiety and stress-related disorders
sleep apnea
snoring
Diagnosis
As orthopnea is usually a symptom of another condition, such as heart failure, a doctor will focus on trying to identify the underlying cause.
The doctor may begin with a physical examination to check the severity and timing of the breathing difficulties. They will also ask about other symptoms and review the person's medical history.
Depending on the suspected cause, the doctor may recommend one or more of the following tests:
X-ray or CT scan of the chest. These tests create an image of the
inside of the chest, which allows the doctor to see if there are any
problems with the lungs or heart.
Electrocardiogram (ECG). This test involves placing sensors on a
person's skin to measure electrical signals from the heart. Doctors
use an ECG to check the functioning of the heart.
Echocardiogram. Also known as an "echo," this is a type of ultrasound
scan that uses sound waves to create an image of the heart. Doctors
use this test to check for any problems with this organ.
Pulmonary function tests. These tests include spirometry, which involves
breathing into a machine. A doctor can use the results to determine
how well the lungs are functioning.
Arterial blood gas. This is a type of blood test that checks whether
a person is getting enough oxygen.
Blood tests. These involve taking a small sample of a person's blood,
and doctors use them to check for signs of a wide range of conditions.
