| ICD-10 | R06.4 |
|---|---|
| ICD-9 | 786.01 |
In medicine, hyperventilation (or overbreathing) is the state of breathing faster and/or deeper than necessary, thereby reducing the carbon dioxide concentration of the blood below normal. A symptom' (from Greek σύμπτωμα, "accident misfortune that which befalls" from συμπίπτω, "I befall" from A Sign is an indication of some fact or quality and a medical sign is an objective indication of some medical fact or quality that is detected by a Physician The International Statistical Classification of Diseases and Related Health Problems (most commonly known by the abbreviation ICD) provides codes to classify Diseases The International Statistical Classification of Diseases and Related Health Problems 10th Revision ( ICD -10) is a coding of diseases and signs symptoms abnormal findings R00-R69 - Symptoms and Signs (R00-R09 Circulatory and Respiratory systems ( Abnormalities of Heart beat The International Statistical Classification of Diseases and Related Health Problems (most commonly known by the abbreviation ICD) provides codes to classify Diseases The following is a list of codes for International Statistical Classification of Diseases and Related Health Problems. Medicine is the art and science of healing It encompasses a range of Health care practices evolved to maintain and restore Human Health by the Breathing takes Oxygen in and Carbon dioxide out of the body Aerobic Organisms require oxygen to create energy via respiration, in Carbon dioxide ( Chemical formula:) is a Chemical compound composed of two Oxygen Atoms covalently bonded to a single Blood is a specialized Bodily fluid that delivers necessary substances to the body's cells such as nutrients and oxygen—and transports Waste products [1]
Hyperventilation can, but does not necessarily always cause symptoms such as numbness or tingling in the hands, feet and lips, lightheadedness, dizziness, headache, chest pain, slurred speech and sometimes fainting, particularly when accompanied by the Valsalva maneuver. The Valsalva maneuver is performed by forcibly exhaling against a closed airway Sometimes hyperventilation is induced for these same effects.
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Causes
Stress or anxiety commonly are causes of hyperventilation; this is known as hyperventilation syndrome. Anxiety is a physiological and psychological state characterized by Cognitive, Somatic, Emotional and Behavioral components In Psychiatry, hyperventilation syndrome ( HVS) is an disorder that often presents with Chest pain and a tingling sensation of the fingertips ( Paresthesia Hyperventilation can also be brought about voluntarily, by taking many deep breaths. Hyperventilation can also occur as a consequence of various lung diseases, head injury, or stroke (central neurogenic hyperventilation, apneustic respirations, ataxic respiration, Cheyne-Stokes respirations or Biot's respiration). lung is the essential Respiration organ in air-breathing Animals including most Tetrapods a few Fish and a few Snails The most primitive A stroke is the rapidly developing loss of brain functions due to a disturbance in the blood vessels supplying blood to the brain Central neurogenic hyperventilation is an abnormal pattern of breathing characterized by deep and rapid breaths Ataxic respiration is an abnormal pattern of breathing characterized by complete irregularity of breathing with irregular pauses and increasing periods of Apnea. Cheyne-Stokes respiration (also known as periodic breathing) is an abnormal pattern of Breathing characterized by oscillation of ventilation between Apnea Biot's respiration, sometimes also called cluster respiration, is an abnormal pattern of breathing characterized by groups of quick shallow inspirations followed by regular Lastly, in the case of metabolic acidosis, the body uses hyperventilation as a compensatory mechanism to increased acidity of the blood. Acidosis is an increased Acidity (ie an increased Hydrogen ion Concentration) In the setting of Diabetic Ketoacidosis, this is known as Kussmaul breathing - characterized by long, deep breaths. Diabetic ketoacidosis (DKA is a life-threatening complication in patients with diabetes mellitus Kussmaul breathing is the very deep and labored Breathing with normal or reduced frequency found among people with severe Acidosis; it is a form of Hyperventilation
Hyperventilation is not the same as hyperpnoea. In hyperpnoea, increased ventilation is appropriate for a metabolic acidotic state, this is also known as respiratory compensation. Whereas in hyperventilation, increased ventilation is inappropriate for the metabolic state of blood plasma.
Mechanism
In normal breathing, both the depth and frequency of breaths are varied by the neural system primarily in order to maintain normal amounts of carbon dioxide but also to supply appropriate levels of oxygen to the body's tissues. This is mainly done by measuring the carbon dioxide content of the blood; normally, a high carbon dioxide concentration signals a low oxygen concentration, as we breathe in oxygen and breathe out carbon dioxide at the same time, and the body's cells use oxygen to burn fuel molecules to carbon dioxide.
The gases in the alveoli of the lungs are nearly in equilibrium with the gases in the blood. An alveolus (plural alveoli, from Latin alveolus, "little cavity" is an anatomical structure that has the form of a hollow cavity Blood is a specialized Bodily fluid that delivers necessary substances to the body's cells such as nutrients and oxygen—and transports Waste products Normally, less than 10% of the gas in the alveoli is replaced each breath. Deeper or quicker breaths exchange more of the alveolar gas with air and have the net effect of drawing more carbon dioxide out of the body, since the carbon dioxide concentration in normal air is very low.
The resulting low concentration of carbon dioxide in the blood is known as hypocapnia. Hypocapnia or hypocapnea also known as hypocarbia, sometimes incorrectly called acapnia, is a state of reduced Carbon dioxide in the Blood Since carbon dioxide is held in the blood mostly in the form of carbonic acid, hypocapnia results in the blood becoming alkaline, i. Carbonic acid (ancient name acid of air or aerial acid) has the formula H2CO3 In Chemistry, an alkali (from Arabic: Al-Qaly القلي القالي) is a basic, ionic salt of an Alkali metal e. the blood pH value rises. pH is the measure of the acidity or alkalinity of a Solution. (Normally, this alkalosis would automatically be countered by reduced breathing, but for various reasons this doesn't happen when the neural control is not present. Alkalosis refers to a condition reducing Hydrogen ion concentration of arterial Blood plasma ( alkalemia) )
If carbon dioxide levels are high, the body assumes that oxygen levels are low, and accordingly, the brain's blood vessels dilate to assure sufficient blood flow and supply of oxygen. Conversely, low carbon dioxide levels (e. g. from hyperventilation) cause the brain's blood vessels to constrict, resulting in reduced blood flow to the brain and lightheadedness. The alkalinization of blood due to hypocapnia is the mechanism by which vessels constrict; it is theorized that myofibrillar calcium sensitivity is increased in the presence of low hydrogen ion concentration. Hypocapnia or hypocapnea also known as hypocarbia, sometimes incorrectly called acapnia, is a state of reduced Carbon dioxide in the Blood Myofibrils (obsolete term sarcostyles) are cylindrical Organelles found within Muscle cells They are bundles of actomyosin filaments
The high pH value resulting from hyperventilation also reduces the level of available calcium (hypocalcemia), which affects the nerves and muscles, causing constriction of blood vessels and subsequent parasthesia and lightheadedness. Calcium (ˈkælsiəm is the Chemical element with the symbol Ca and Atomic number 20 In Medicine, hypocalcaemia is the presence of low serum Calcium levels in the Blood, usually taken as less than 2 Paresthesia (pron /ˌpɛɹɪsˈθiʒə/ paraesthesia in British English, pron This occurs because alkalinization of the plasma proteins (mainly albumin) increases their calcium binding affinity, thereby reducing free ionized calcium levels.
Therefore, there are two main mechanisms that contribute to the cerebral vasoconstriction that is responsible for the lightheadedness, parasthesia, and fainting often seen with hyperventilation. Vasoconstriction is the narrowing of the blood vessels resulting from contraction of the muscular wall of the vessels particularly the large Arteries, Arterioles Light-headedness is a common and often unpleasant sensation of Dizziness and/or feeling that one may be about to faint, which may be transient recurrent or occasionally Paresthesia (pron /ˌpɛɹɪsˈθiʒə/ paraesthesia in British English, pron One mechanism is that low carbon dioxide (hypocapnia) causes decreased hydrogen ion concentration (respiratory alkalosis), which causes blood vessels to constrict. Hypocapnia or hypocapnea also known as hypocarbia, sometimes incorrectly called acapnia, is a state of reduced Carbon dioxide in the Blood Respiratory alkalosis results from increased alveolar respiration ( Hyperventilation) leading to decreased plasma Carbon dioxide concentration The other mechanism is that the decrease in hydrogen ions (alkalosis) causes decreased freely ionized blood calcium, thereby causing cell membrane instability and subsequent vasoconstriction. Alkalosis refers to a condition reducing Hydrogen ion concentration of arterial Blood plasma ( alkalemia)
Though it seems counterintuitive, breathing too much can result in a decrease in the oxygen supply to the brain. Doctors sometimes artificially induce hyperventilation after head injury to reduce the pressure in the skull, though the treatment has potential risks. [2]
References
- ^ Kenneth Baillie and Alistair Simpson. Hyperventilation calculator. Apex (Altitude Physiology EXpeditions). Retrieved on 2006-08-10. Year 2006 ( MMVI) was a Common year starting on Sunday of the Gregorian calendar. Events 612 BC - Killing of Sinsharishkun, King of Assyrian Empire - Online interactive oxygen delivery calculator that mimicks hyperventilation
- ^ Stocchetti N, Maas AI, Chieregato A, van der Plas AA (2005). "Hyperventilation in head injury: a review". Chest 127 (5): 1812-27. doi:. A digital object identifier ( DOI) is a permanent identifier given to an Electronic document. PMID 15888864.
See also
- Hypoventilation, too shallow or too slow breathing
- Control of respiration
- Respiratory alkalosis
- Shallow water blackout, the role of hyperventilation in some drowning incidents
- Hyperpnea
- Tachypnea
External Links
- Seizures due to hypocalcaemia worsened by shifting towards alkalosis by bicarbonate therapy
- Electrolytes
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