Orthopnea

Orthopnea

ICD-10	R06.0
ICD-9	786.02

Orthopnea or orthopnoea (Greek from ortho, straight + pnoia, breath) is shortness of breath (dyspnea) which occurs when lying flat,^[1] 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").^{[citation needed]}

Causes

Orthopnea is due to increased distribution of blood to the pulmonary circulation while recumbent,^[2] but usually can be attributed to a more fundamental cause.

Orthopnea is often a symptom of left ventricular heart failure and/or pulmonary edema.^[3][4] It can also occur in those with asthma and chronic bronchitis, as well as those with sleep apnea or panic disorder.^{[citation needed]} It is also associated with polycystic liver disease.^{[citation needed]}

See also

• Paroxysmal Nocturnal Dyspnea
• Trepopnea

References

1. ^ "orthopnea" at Dorland's Medical Dictionary
2. ^ "Dyspnea, Orthopnea, and Paroxysmal Nocturnal Dyspnea -- Clinical Methods -- NCBI Bookshelf". http://www.ncbi.nlm.nih.gov/bookshelf/br.fcgi?book=cm&part=A454. Retrieved 2009-03-14. 
3. ^ Torchio R, Gulotta C, Greco-Lucchina P, et al. (August 2006). "Orthopnea and tidal expiratory flow limitation in chronic heart failure". Chest 130 (2): 472–9. doi:10.1378/chest.130.2.472. PMID 16899847. http://www.chestjournal.org/cgi/pmidlookup?view=long&pmid=16899847. 
4. ^ Walker, H. Kenneth; Vaskar Mukerji (1990). Clinical Methods. Butterworths. ISBN 0407028536. http://www.ncbi.nlm.nih.gov/bookshelf/br.fcgi?book=cm&part=A454. Retrieved 2009-01-16.