Journal Information
Vol. 42. Issue 5.
Pages 211-217 (May 2006)
Share
Share
Download PDF
More article options
Vol. 42. Issue 5.
Pages 211-217 (May 2006)
Original Articles
Full text access
Descriptors of Breathlessness in Mexican Spanish
Visits
4526
J.C. Vázquez-Garcíaa,
Corresponding author
jcvaz@prodigy.net.mx

Correspondence: Dr. J.C. Vázquez-García. Calzada de Tlalpan, 4.502. 14080 México DF. México
, C.A. Balcázar-Cruza, G. Cervantes-Méndeza, R. Mejía-Alfaroa, J. Cossío-Alcántarab, A. Ramírez-Venegasc
a Departamento de Fisiología Respiratoria, Instituto Nacional de Enfermedades Respiratorias, México DF, Mexico
b Departamento de Hospitalización, Instituto Nacional de Cardiología Ignacio Chávez, México DF, Mexico
c Clínica de EPOC, Instituto Nacional de Enfermedades Respiratorias, México DF, Mexico
This item has received
Article information
Objective

Breathlessness is the most common symptom of cardiovascular or pulmonary disease. The term encompasses a wide range of descriptors used by patients, however. Identifying those descriptors can be useful for analyzing symptoms and understanding how they arise. The aim of this study was to characterize the descriptors of breathlessness used in Mexican Spanish and to consider their association with various states of respiratory distress and cardiovascular or pulmonary disease.

Material and methods

A questionnaire was based on 21 descriptors of breathlessness, some of which had no equivalents in English. The subjects included 15 healthy individuals during a cardiopulmonary stress test, 13 healthy subjects after a carbon dioxide rebreathing procedure, and 10 healthy women during pregnancy. We also included 16 patients with confirmed heart disease in stable condition, 15 patients during exacerbation of asthma, 20 with stable chronic obstructive pulmonary disease, and 15 with diffuse interstitial lung disease also in stable condition. Descriptors of breathlessness were then grouped based on the results of cluster analysis.

Results

Seven clusters of phrasal descriptors were identified as possibly representative of types of dyspnea. These clusters of descriptors were categorized as follows: agitation, suffocation, smothering, inhalation, exhalation, panting, and rapidity. Associations between types of dyspnea and the groups of participants were identified based on how frequently they used the terms.

Conclusions

At least 7 clusters or groups of descriptors of breathlessness were identified as equivalent to 7 types of dyspnea; some items have no equivalent in English. Healthy subjects with respiratory distress or certain groups of patients with cardiovascular or pulmonary disease are associated with certain types of dyspnea.

Key words:
Dyspnea
Descriptors of breathlessness
Cluster analysis
Asthma
Chronic obstructive pulmonary disease
Objetivo

La disnea es el síntoma más frecuente en la en-fermedad cardiovascular o pulmonar. Sin embargo, el término engloba un número variado de descriptores que suelen usar o identificar los pacientes. Identificar estos descriptores puede ser de utilidad semiológica y para la compresión de su patogenia. El objetivo del presente estudio ha sido caracteri-zar los descriptores de disnea utilizados en español mexica-no y su asociación con diferentes estados de estrés respirato-rio o enfermedad cardiovascular o pulmonar.

Material y métodos

Se estructuró un cuestionario de disnea basado en 21 descriptores, algunos sin equivalentes en idio-ma inglés. Se estudió a 15 sujetos sanos durante una prueba de ejercicio cardiopulmonar, a 13 durante una prueba de hiper-capnia y a 10 mujeres embarazadas. Asimismo, se incluyó a 16 pacientes estables con cardiopatía demostrada, a 15 pacientes con crisis asmática, a 20 con enfermedad pulmonar obstructiva crónica estable y a 15 con neumopatía intersticial difusa tam-bién estable. La agrupación de los diferentes descriptores de disnea se determinó por análisis de conglomerados.

Resultados

Se encontraron 7 conglomerados o asociaciones de descriptores que pueden interpretarse como tipos de disnea. Estos grupos de frases descriptivas se pueden englo-bar bajo los siguientes conceptos: agitación, asfixia, sofocación, inhalación exhalación, jadeo y rapidez. Se encontraron algunas asociaciones entre tipos de disnea y los grupos estu-diados sobre la base de la frecuencia de uso de los términos.

Conclusiones

Existen al menos 7 conglomerados o asociaciones de descriptores de disnea que equivalen a 7 tipos de disnea; algunos de los descriptores carecen de equivalen-te en inglés. Los sujetos sanos en estrés respiratorio o algunos grupos de pacientes con enfermedad cardiovascular o pulmonar se asociaron a tipos específicos de disnea.

Palabras clave:
Disnea
Decriptores de disnea
Análisis de conglomerados
Asma
Enfermedad pulmonar obstructiva crónica
Full text is only aviable in PDF
REFERENCES
[1]
American Thoracic Society.
Dyspnea. Mechanisms, assessment, and management: a consensus statement.
Am J Respir Crit Care Med., 159 (1999), pp. 321-340
[2]
MT Tobin.
Dyspnea. Pathophysiologic bases, clinical presentation and managment.
Arch Int Med., 150 (1990), pp. 1604-1613
[3]
DM Mahler.
Dyspnea, Marcel Decker Inc, (1998),
[4]
K Kroenke, ME Arrington, AD Mangelsdorff.
The prevalence of symptoms in medical out-patients and the adequacy of therapy.
Arch Intern Med., 150 (1990), pp. 1685-1689
[5]
MR Pratter, FJ Curley, J Dubois, RS Irwin.
Cause and evaluation of chronic dyspnea in a pulmonary disease clinic.
Arch Intern Med., 149 (1989), pp. 2277-2282
[6]
NS Cherniak, MD Altose.
Mechanisms of dyspnea.
Clin Chest Med., 8 (1987), pp. 207-214
[7]
A Ramírez-Venegas, C Sánchez, J Regalado, RH Sansores.
Similitudes y diferencias en el grado de disnea durante el ejercicio en pacientes con EPOC y fibrosis pulmonar.
Arch Bronconeumol., 37 (2001), pp. 221-226
[8]
E Martínez-Moragón, M Perpiñá, A Belloch, A de Diego, ME Martínez-Francés.
Percepción de la disnea durante la broncoconstricción aguda en pacientes con asma.
Arch Bronconeumol., 39 (2003), pp. 67-73
[9]
ME Martínez-Francés, M Perpiñá-Tordera, A Belloch-Fuster, EM Martínez-Moragón, A de Diego-Damiá.
¿Cómo valorar la percepción de la disnea inducida en la EPOC?.
Arch Bronconeumol., 40 (2004), pp. 149-154
[10]
E Martínez-Moragon, M Perpiñá, A Belloch, A de Diego, ME Martínez-Francés.
Concordancia entre la percepción de la disnea del asmático durante la obstrucción aguda y crónica.
Arch Bron coneumol., 41 (2005), pp. 371-375
[11]
G Scano, L Stendardi, M Grazzini.
Understanding dyspnoea by its language.
Eur Respir J., 25 (2005), pp. 380-385
[12]
PM Simon, RM Schwartzstein, JW Weiss, K Lahive, V Fencl, M Teghtsoonian, et al.
Distinghisable sensations of breathlessness induced in normal volunteers.
Am Rev Respir Dis., 140 (1989), pp. 1021-1027
[13]
PM Simon, RM Schwartzstein, JW Weiss, V Fencl, M Teghtsoonian, SE Weinberger.
Distinguishable types of dyspnea in patients with shortness of breath.
Am Rev Respir Dis., 142 (1990), pp. 1009-1014
[14]
MW Elliot, L Adams, A Cockcroft, KD Macrae, K Murphy, A Guz.
The language of breathlessness.
Am Rev Respir Dis., 144 (1991), pp. 826-832
[15]
DA Mahler, A Harver, T Lentine, JA Scott, K Beck, RM Schwartzstein.
Descriptors of breathlessness in cardiopulmonary diseases.
Am J Respir Crit Care Med., 154 (1996), pp. 1357-1363
[16]
ML Moy, ML Lantin, A Harper, RM Schwartzstein.
Language of dyspnea in assessment of patients with acute asthma treated with nebulized albuterol.
Am J Respir Cri Care Med., 158 (1998), pp. 749-753
[17]
JC Vázquez, SL Arellano, J Regalado, JR Pérez Padilla.
Respuesta ventilatoria a hipoxia e hipercapnia en sujetos sanos de la ciudad de México.
Rev Inv Clin., 50 (1998), pp. 323-329
[18]
StatSoft Inc..
Electronic statistics textbook [accessed 21 Jun 2005].
[19]
MS Kramer, AR Feinstein.
The biostatistics of concordance.
Clin Pharmacol Ther., 29 (1981), pp. 111-123
[20]
RV Lourenco, GM Turino, LAG Davidson, AP Fishman.
The regulation of ventilation in diffuse pulmonary fibrosis.
Am J Med., 38 (1965), pp. 199-216
[21]
JC Vázquez, JR Pérez Padilla.
Effect of oxygen on sleep and breathing in patients with interstitial lung disease at moderate altitude.
Respiration, 68 (2001), pp. 584-589
[22]
AP Binks, SH Moosavi, RB Banzett, RM Schwartztein.
“Tightness” sensation of asthma does not arise from the work of breathing.
Am J Respir Crit Care Med., 165 (2002), pp. 78-82
[23]
GE Hardie, S Janson, WM Gold, V Carrieri-Kholman, HA Boushey.
Word descriptors used by African-American and white asthma patients during induced bronchoconstriction.
Chest, 117 (2000), pp. 935-943
Copyright © 2006. Sociedad Española de Neumología y Cirugía Torácica (SEPAR)
Archivos de Bronconeumología
Article options
Tools

Are you a health professional able to prescribe or dispense drugs?