Abnormal Finding
Minor changes in rate and rhythm of respiration occur due to anxiety and while it may represent an abnormality, it may not be significant.
- Rate
- Rate below 10/min: Bradypnea: (Narcotics, raised intracranial tension, myxedema)
- Rate above 20/min: Tachypnea: (Interstitial, vascular and multitude of diseases, anxiety)
- Pattern
- Periodic breathing. Cyclical increase and decrease in depth of respiration: Cheyne-stokes breathing: (CHF, Cerebrovascular insufficiency)
- Slow deep breathing: Kussmaul: (Ketoacidosis)
- Totally irregular with no pattern:Biot's breathing: (CNS injury)
- Periodic deep breathing: Sighs: (Anxiety state)
- Instead of simultaneous chest and abdominal expansion with inspiration abdomen retracts while chest expands: Abdominal paradox: (Diaphragmatic paralysis)
- On the side of unstable chest wall hemithorax retracts while the normal side expands with inspiration: Thoracic paradox: (Flail chest)
- With lips pursed patient controls expiration slowly: Pursed lip breathing: (Obstructive lung disease)
- No abdominal component : ( Acute abdomen)
- No thoracic component: (Pleurisy, Chest wall pain, Ankylosing spondylitis)
- Discomfort
- Labored breathing: (Heart and Lung diseases)
- Unable to assume supine position because of worsening shortness of breath: Orthopnea: (CHF, Diaphragmatic paralysis, SVC syndrome, Anterior mediastinal mass)
- Unable to erect position because of worsening shortness of breath, more comfortable in supine position : Platypnea: (Pulmonary spiders in cirrhotic)