Dyspnea is the main symptom perceived by patients affected by chronic respiratory diseases. It derives from a complex interaction of signals arising in the central nervous system, which is connected through afferent pathway receptors to the peripheral respiratory system (airways, lung, and thorax). Notwithstanding the mechanism that generates the stimulus is always the same, the sensation of dy...

Numerous postpneumonectomy complications exist. We present a rare clinical case of postpneumonectomy exertional dyspnea revealing compression of the mitral annulus by the descending aorta. The patient was 42-year-old former smoker with pulmonary emphysema. He has been operated on, in 2012 (i.e., right pneumonectomy). Before the surgery, the patient was a recreational runner. However, after some...

Introduction: α1-antitrypsin deficiency (α1-ATD) is one of the most common genetic disorders in white race, a usual cause of liver disease in children, and hepatopulmonary involvement in children and adult. The aim of this case description is presenting a child with early lung disease without liver parenchymal disorder. Case presentation: We describe a 13 year old boy because of exertional dysp...

A 67-year-old male presented to the hospital emergency department with a 3-day history of decreased exercise tolerance, fatigue and exertional chest tightness. These symptoms began after an initial episode of prolonged chest pain associated with diaphoresis and dyspnea.. The admission electrocardiogram (EKG) and cardiac “markers” were consistent with a recent inferolateral myocardial infarction...

A previously healthy 52-year-old male presented with a several week history of progressive exertional dyspnea. Physical examination and electrocardiogram were unremarkable. A transthoracic echocardiogram (TTE) was performed (Fig. 1). Initially it was thought that a membrane was within a large left atrium (LA). To further delineate the LA and its anatomy, peripheral injection of sonicated contra...

Although the complex molecular mechanisms responsible for the vasculopathy of pulmonary artery hypertension (PAH) have only recently begun to be unraveled, it has been recognized for decades that the most significant determinant of both symptoms and survival in PAH is the degree of cardiac impairment that results from the increased right ventricular afterload.1 Exertional dyspnea, the most freq...

The evaluation of dyspnea and its responsiveness to therapy in COPD should consider the multidimensional nature of this symptom in each of its sensory-perceptual (intensity, quality), affective and impact domains. To gain new insights into mechanisms of dyspnea relief following pulmonary rehabilitation (PR), we examined effects on the major domains of dyspnea and their interaction with physiolo...

INTRODUCTION Exercise limitation, dynamic hyperinflation, and exertional dyspnea are key features of symptomatic chronic obstructive pulmonary disease (COPD). We assessed the effects of glycopyrronium bromide (NVA237), a once-daily, long-acting muscarinic antagonist, on exercise tolerance in patients with moderate to severe COPD. METHODS Patients were randomized to a cross-over design of once...