Breathing Pain & Discomfort

See also Chest Pain for more Cardiac and Heart Signs

Acute Pulmonary Edema
Acute shortness of breath with possible sweating and cyanosis. There may be frothy sputum with a pink tinge due to a ruptured blood vessel.
Often related to cardiac disorders.

Cavitation
Small chest movements over the large cavity with possible post-tussive suction sounds if the cavity communicates with a bronchus. Other signs may be sucking, hissing and crackles.

Crackles – Crepitations
Crackles which are heard during inspiration due to the lower smaller airways snapping open due to collapse. The coarse crackles may be initiated by fluid bubbling in the airways as in Pulmonary Edema, Bronchopneumonia or Bronchiectasis.

Bronchial Narrowing
Generalized shortness of breath and will need the use of accessory muscles of respiration to elevate the upper chest to aid in inspiration. There is commonly the concomitant symptoms of wheezing.

Dyspnoea – Breathlessness
Difficulty in breathing or shortness of breath with possible heavy sweating, rapid heartbeat and wheezing.

Haemoptysis
Coughing up of blood from the lungs. Often due to infection in the chest in which blood will be mixed with sputum. If it is blood alone it may be a symptoms of pulmonary infarction. Tuberculosis, lung abscesses and cavitating carcinomas are just some of the causes of haemoptysis.

Lung Cancer
May show symptoms of persistent cough, dyspnea (breathing difficulty) pus or blood streaked sputum, chest pain and possible attacks of bronchitis or pneumonia. 75% of the cases of lung cancer are linked with cigarette smoking. Lung cancer is a malignant disorder that develops most often in scarred or diseased lung and uis usually far advanced when detected.

Lung Collapse
Chest movements on effected side will diminish and the trachea may be pulled over to one side if an upper lobe is effected. If the lower lobe is effected the heart may be pulled to one side.

Orthopnoea
Dyspnoea (shortness of breath) which develops when patient lies down flat but is relieved when sitting up. Patients will not be able to sleep in a traditional laying position. Often related to cardiac disorders.

Paroxysmal Nocturnal Dyspnoea
Patient will wake during the night due to severe shortness of breath and will sit up or stand up abruptly to help them breath. Once sitting up or standing shortness of breath is usually relieved in several minutes. This pattern is similar to Orthopnoea. Often related to cardiac disorders.

Pleural Rub
Scratchy, creaking sound produced when one layer of irritated pleura has to slide over the other. The rub will produce well localized chest pain

Pneumothorax
A Pneumothorax is a collection of air or gas in the chest causing the lung to collapse. It may be the result of an open chest wound allowing air to enter into the cavity. They generally begin with sudden sharp chest pain, rapid breathing and possible coughing.
Movement of affected side may be reduced and the mediastinum may be pushed away from the effected side of the chest.

Pulmonary Disease
Pulmonary disease generally consists of a cough, chest pain, dyspnea (difficulty breathing), bloody sputum, abnormal breathing sounds and wheezing. There also may be arm and shoulder pain or pain in the calf of the leg. If severe there also may facial edema, headaches, hoarseness and pain in the joints.

Pulmonary Edema
Fluid in lung tissues giving rise to quick breathing, shallow breathing, dyspnea (difficult breathing), restlessness, hoarseness and pale or bluish skin due to a general oxygen deficiency to there tissue. Pulmonary edema is often caused by congestive heat failure but can also be a side effect of drugs, infections, inflammation of the pancrease or kidney failure. Pulmonary edema is a common symptom following a stroke, near drowning, inhalation of poison gas or rapid flow of blood in the veins.

Chronic Obstructive Pulmonary Disease – COPD
Incurable condition in which the lungs are able to take in less and less air over a period of time. General symptoms are similar to that of pulmonary disease with more emphasis of difficulty exercising, difficulty exhaling with more chronic symptoms (like cough). COPD is directly related to chronic bronchitis, emphysema and asthma.

Wheezing
Possibly an episode of asthma caused by turbulent airflow in narrowed bronchial airways which is more prominent during expiration.

Reference:

Clinical History Taking and Examination
Second Edition – An Illustrated Colour Text
P.D. Welsby
Churchill Livingstone – 2002


Mosby Medical Encyclopedia
Revised Edition
Walter D. Glanze, Kenneth n. Anderson, Lois E. Angerson
Penguin Books