DOCTOR'S VIEW ARCHIVE
Shortness of Breath & VP Cheney
Medical Authors and Editors: Barbara K. Hecht,
Frederick Hecht, M.D.
November 15, 2004 -- Vice President Dick Cheney
complained of shortness of breath and underwent tests at a Washington hospital
this weekend. There was
concern because the vice president has had significant heart problems for years
but Mr. Cheney was able to go home from the hospital after three hours.
His cardiologist, Dr. Jonathan Reiner, issued a statement saying: "Tests
ruled out any cardiac cause of the vice president's symptoms. Tests also ruled
out pneumonia and other pulmonary causes. The vice president
likely has a viral upper-respiratory infection."
Formal medical statements tend to
be just that -- formal. To put Mr. Cheney's condition into everyday words, we
might say: "He did not have a heart attack or pneumonia. He probably just has a
Shortness of Breath
Shortness of breath, medically known as dyspnea, is an important symptom but
there is no standard definition for it. However, the causes of shortness of
breath or dyspnea fall into simple categories. These categories include anxiety,
muscle and nerve diseases, heart disease, lung vessel
diseases, lung disease, and obstruction to airflow.
Anxiety can lead to acute or chronic hyperventilation (excessively rapid
breathing). An average 150 pound (70 kilogram) adult breaths at an average rate
of 14 breaths per minute at rest. Excessively rapid breathing is referred to as
hyperventilation. It is a common cause of shortness of breath.
Muscle & Nerve Diseases
Numerous diseases of muscles and the nervous system can lead to shortness of
breath by weakening the body's capacity for opening the lungs up for
respiration. Examples of muscle diseases include muscular dystrophy,
polymyositis, and dermatomyositis. Examples of nervous
system diseases that can cause shortness of breath include Lou Gehrig's disease
(ALS) and multiple sclerosis.
Many conditions that affect the heart and its capacity to move blood through the
lungs can lead to shortness of breath. These conditions include a heart attack
(that Mr. Cheney feared), congestive heart failure, and heart valve disease.
Lung Vessel Disease
The blood vessels that transport blood to and from the lungs and permit the
vital exchange of carbon dioxide for oxygen can be compromised by disease and
lead to shortness of breath. Examples of conditions that affect these blood
vessels include pulmonary embolism (a clot in the lungs), pulmonary hypertension
(high blood pressure in the pulmonary artery), and pulmonary vasculitis (inflammation of pulmonary vessels).
Lung diseases that can cause shortness of breath include infections such as
pneumonia and bronchitis, lung cancer and cancer that has spread to the lung,
chemical and radiation toxicity to the lung (including radiation therapy),
occupational toxicities (such as from silicon in mines), sarcoidosis,
hemosiderosis, tuberculosis, fungus infections such histoplasmosis and coccidiomycosis
(valley fever), allergic reactions (hypersensitivity pneumonitis) drug toxicity, and connective tissue diseases such as
rheumatoid arthritis and lupus.