Paroxysmal nocturnal dyspnoea

PND is acute, severe, brcathlessness that wakes the patient from steep. The patient has to sit upright gasping in bed or sitting on the edge of the bed. The patient may even get out of bed, occasionally throwing open the windows in an attempt to relieve the distress. The intensity of the symptom is often described as akin to suffocation. Characteristically, the patient has a cough producing frothy sputum which may be streaked with blood. The mechanism is explained in Figure 3.2, which also lists the causes. Paroxysmal nocturnal dyspnoea has to be distinguished from nocturnal asthma (Ch. 4, p. ยก39).

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