Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0392680 (shortness of breath)
 5,217 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Infants with significant left-to-right shunts due to ventricular septal defects and atrioventricular canal defects commonly present with respiratory symptoms, such as shortness of breath while feeding, tachypnea, and wheezing. Radiographs show hyperinflated lungs as well as cardiomegaly and increased vascularity. Enlarged vessels adjacent to small compressible airways as well as peribronchial interstitial edema may cause diffuse air trapping. In this study, using an automated planimetric device, we measured the total thoracic, cardiomediastinal, and lung volumes in a group of patients with large left-to-right shunts as well as in a group of normal controls and found that, as expected, all volumes were significantly increased in the abnormal group. We also tried to correlate these volumes (corrected for patient size) with the degree of left-to-right shunt and found that there was no significant correlation between the cardiac or lung volumes and shunt size as estimated by cardiac catheterization.
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PMID:Hyperinflation of the lungs in infants with large left-to-right shunts. 338 15

Between 1975 and 1982 a total of 47 cases of high-altitude pulmonary edema occurred in Vail, Colorado, elevation 2,500 m (8,200 ft). All occurred in visitors from lower altitudes. The mean age of the patients was 35.6 years, and 93% were men. Most patients had tachycardia, tachypnea and fever. The mean time of onset of cough and shortness of breath was 2.5 days after arrival. The average total ascent of the patients was 2,330 m (7,644 ft) in less than one day from a mean residential elevation of 170 m (556 ft). Also, 91% of the cases occurred between December and April, when the average daily temperature was -4.3 degrees C (24.3 degrees F) and the ambient barometric pressure was 22.37 in of mercury.
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PMID:High-altitude pulmonary edema in Vail, Colorado, 1975-1982. 371 17

Brachial neuritis with bilateral hemidiaphragmatic paralysis has been reported in two previous cases in the literature. We report a patient who experienced severe right shoulder discomfort three weeks prior to hospital admission which evolved to include both shoulders. Two weeks prior to admission he noticed the onset of discomfort in breathing in the supine position and shortness of breath with minor exertion. The admitting diagnoses were myocardial infarction due to significant ECG changes and idiopathic elevated bilateral hemidiaphragms. The patient had findings significant for tachypnea, dyspnea, decreased breath sounds at the bases bilaterally, impaired motion of the bilateral lung bases on inspiration and paradoxical respirations. Comprehensive medical testing and evaluation revealed bilateral elevated hemidiaphragms and vital capacity 40% of normal. Weakness of the proximal shoulder girdle and bicep musculature bilaterally was noted. Electromyography was significant for reduced recruitment pattern in the bilateral shoulder girdle musculature. Nerve conduction studies suggested bilateral phrenic neuropathy. This case is an unusual presentation of brachial neuritis affecting the bilateral shoulder girdle with phrenic nerve involvement. The differential diagnosis of acute shoulder pain associated with respiratory symptomatology should therefore include brachial neuritis.
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PMID:Brachial neuritis involving the bilateral phrenic nerves. 380 Jun 25

Acute anaphylactoid reactions occurred immediately after initiation of intravenous infusions of cyclosporine in three patients post-organ transplantation. Shortness of breath, flushing, tachypnea, chest pain, pruritus, or urticaria were noted; rapid recovery followed cessation of drug infusion. Subsequently, oral cyclosporine has been used in each patient without recurrence of the observed reaction. The presence of Cremophor EL as an emulsifying agent in the parenteral dosage formulation of cyclosporine is a likely etiology for this acute adverse reaction. Slowed rates of drug infusion and antihistamine premedication may permit continued intravenous cyclosporine use in affected patients.
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PMID:Anaphylactoid reactions associated with parenteral cyclosporine use: possible role of Cremophor EL. 400 35

A case report of pulmonary edema associated with the use of a betamimetic agent in preterm labor is reported. A 31-year-old, black multigravida woman, 28 weeks pregnant, was admitted to the hospital with dysuria, vaginal bleeding, and uterine contractions. She had experienced premature labor in her previous pregnancies, and she had a history of kidney stones, confirmed by pyelography, and repeated urinary tract infections. Eighteen hours after admission, the contractions were occurring every five minutes. Terbutaline sulfate constant infusion (10-20 micrograms/min) was started. By hospital day 2, the uterine contractions were occurring every 1-2 minutes and lasting 50 seconds. The terbutaline therapy was discontinued, and isoxsuprine hydrochloride infusion was started at 240 micrograms/min and gradually increased to 800 micrograms/min. The patient complained of smothering and became tachypneic after one hour and 40 minutes of therapy. The shortness of breath and tachypnea continued in spite of the administration of oxygen and positional changes. The isoxsuprine was discontinued. The diagnosis of pulmonary edema was confirmed by abnormal findings in the chest roentgenogram, bilateral rales, and a decrease in arterial blood oxygen pressure. A literature review of pulmonary edema associated with the administration of beta sympathomimetic drugs is presented, which suggests this adverse effect is multifactorial in origin. Precipitating factors may include corticosteroids, fluid overload, low levels of serum potassium, twin gestations, a sustained tachycardia greater than 140 beats per minute, undiagnosed cardiopulmonary disease, or catecholamine-induced cardiac injury. Patients requiring betamimetics for the delay of premature labor should be monitored closely to obviate this complication.
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PMID:Pulmonary edema associated with the use of betamimetic agents in preterm labor. 611 3

The clinical pattern of acute lower respiratory tract infection (ALRTI) in children admitted to Port Moresby General Hospital (PMGH) was studied. Most patients (60%) were less than twelve months of age. Common symptoms were cough, fever and shortness of breath. Common signs were crepitations, chest recession, elevated temperature and tachypnoea. Concurrent illness was common, with evidence of malnutrition in 62% patients. Most patients were anaemic (haemoglobin less than 10g per dl). Blood cultures isolated pathogens in 13% of patients in which it was done, the most common isolate being Haemophilus influenzae. Chest radiograph showed most patients had multisegmental changes, with the lower lobes commonly involved. Of the 129 patients, discharges accounted for 106 (82%), while 15 (12%) absconded and eight (6%) died. Of those 121 discharged or absconding, 15 (12%) were readmitted within three months of departure. Sixty-six (51%) patients stayed in hospital for four days or less. Of the eight patients who died, six (75%) were malnourished, six (75%) were less than eighteen months of age, seven (87.5%) were sick for one week or less before admission, five (62.5%) had received antibiotics before admission and chest radiograph showed more lung zones affected than in those not dying. Of the eight patients who died, six had white cell counts (WCC) performed and none of these was more than 30,000.
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PMID:Acute lower respiratory tract infections in children admitted to Port Moresby General Hospital. 633 17

A case of maternal pulmonary edema occurring in a patient in the 32nd week of gestation is presented. This was our first case of pulmonary edema seen during a period of five years' usage of isoxsuprine in the treatment of premature labor. The patient presented was 28 years old, gravida 2, para 1, admitted to the maternity ward with premature uterine contractions. Her past history eliminate cardiac or pulmonary disease. Isoxsuprine therapy was begun with initial dose of 0.04 mg/min. and increased to 0.32 mg/min., the total dose administered was 560 mg during 48 hours. During this period she was given in dexamethasone 24 mg. Fluid balance on the first day of the treatment was +1.7 liters and on the second day +5.2 liters. Forty-eight hours from the commencement of the treatment, the patient experienced shortness of breath and chest pain. Physical examination disclosed wet rales over both lungs, sinus tachycardia and tachypnea. Laboratory examination disclosed hypopotassemia of 3 mEq/liter, hypoxemia (PO2 of 80 torr on 0.5 FiO2 face mask) with mild hyperventilation 28 torr PCO2 with normal ph 7.43. Recognition of the early signs of pulmonary edema enable swift clinical diagnosis and steps to be taken to prevent disasterous condition due to progressive hypoxemia. The prompt treatment in this complication includes discontinuation of isoxsuprine and fluid administration, placement of the patient in an erect position, intravenous furosemid 40 mg, oxygen supplement by face mask and 25 mg of meperidine. The patient's condition dramatically improved though the lung fields became completely clear from wet rales only eight hours from the start of dyspneic attack.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Pulmonary edema occurring after isoxsuprine and dexamethasone treatment for preterm labor: Case report. 666 29

Cardiac tamponade is a rare complication of juvenile rheumatoid arthritis. Three cases seen in the last two years at the Children's Hospital of Philadelphia are reported and compared to four previously reported cases. All three children had systemic-type juvenile rheumatoid arthritis with tachypnea, shortness of breath, and chest pain. Cardiac signs in these children included decreased heart sounds, pericardial friction rub, jugular venous distention, and pulsus paradoxus greater than 12 mm Hg. Roentgenograms of the chest showed cardiomegaly with bilateral pleural effusions. Electrocardiograms showed sinus tachycardia and nonspecific ST-T wave changes. Echocardiograms demonstrated pericardial effusions in all subjects and poor ventricular movements in one child. All three children were treated with short-acting anti-inflammatory drugs and/or prednisone. Pericardiocentesis was performed in two cases. There was no significant morbidity after a mean follow-up of two years.
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PMID:Pericarditis and cardiac tamponade in juvenile rheumatoid arthritis. 727 62

There is little information on the prevalence and clinical presentation of acid-base abnormalities associated with cocaine toxicity. To address these issues, arterial blood gas results were evaluated in 156 cocaine-associated emergency department patient visits. Arterial blood gas results were obtained as part of the patient's clinical assessment. The majority of patients (52%) had a normal pH (7.35 to 7.45). Thirty-three percent of patients were acidotic, with a pH between 6.4 and 7.35. In 33 patients the acidosis was metabolic, with a HCO3- of 14 +/- 6 mmol/L. The acidosis was primarily respiratory in 18 patients, with evidence of hypoventilation. Hypoventilation was generally secondary to chest trauma or decreased mental status. Alkalosis (pH > 7.45) was observed in 15% of patients, and was usually respiratory, as evidenced by tachypnea and a low PCO2. These results indicate that metabolic and respiratory acid-base abnormalities are common during cocaine toxicity. Acidosis and alkalosis were associated with numerous patient presentations, including chest pain, shortness of breath, decreased mental status, trauma, and seizures. Acid-base abnormalities do not appear to be associated with a specific route of cocaine self-administration. Patients with a history of potential cocaine toxicity should be evaluated for acid-base abnormalities.
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PMID:Acid-base abnormalities associated with cocaine toxicity in emergency department patients. 830 47

Pneumonitis is a serious and unpredictable side-effect of treatment with methotrexate (MTX) that may become life-threatening. The clinical and histological features of nine cases of MTX pneumonitis are reported and the literature reviewed. The typical clinical symptoms include progressive shortness of breath and cough, often associated with fever. Hypoxaemia and tachypnoea are always present and crackles are frequently audible. Chest radiography reveals a diffuse interstitial or mixed interstitial and alveolar infiltrate, with a predilection for the lower lung fields. Pulmonary function tests show a restrictive pattern with diminished diffusion capacity. Lung biopsy reveals cellular interstitial infiltrates, granulomas or a diffuse alveolar damage pattern accompanied by perivascular inflammation. These clinical and pathological findings are not specific to MTX pneumonitis and can be seen with other drug-induced lung toxicities. It is important that all patients receiving methotrexate be educated concerning this potential adverse reaction and instructed to contact their physicians should significant new pulmonary symptoms develop while undergoing therapy. If methotrexate pneumonitis is suspected, methotrexate should be discontinued, supportive measures instituted and careful examination for different causes of respiratory distress conducted.
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PMID:Methotrexate pneumonitis: review of the literature and histopathological findings in nine patients. 1070 7


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