Paroxysmal Dyspnea (Paroxysmal Nocturnal Dyspnea)

A disorder characterized by sudden attacks of respiratory distress in at rest patients with HEART FAILURE and PULMONARY EDEMA. It usually occurs at night after several hours of sleep in a reclining position. Patients awaken with a feeling of suffocation, coughing, a cold sweat, and TACHYCARDIA. When there is significant WHEEZING, it is called CARDIAC ASTHMA.

Also Known As:

Paroxysmal Nocturnal Dyspnea; Dyspnea, Paroxysmal; Dyspnea, Paroxysmal Nocturnal; Cardiac Asthma; Cardiac Asthmas; Nocturnal Dyspnea, Paroxysmal; Asthma, Cardiac

Networked: 84 relevant articles (8 outcomes, 6 trials/studies)

Relationship Network

Disease Context: Research Results

Related Diseases

1.	Heart Failure
2.	Respiratory Sounds (Crackle)
3.	Asthma (Bronchial Asthma)
4.	Dyspnea (Shortness of Breath)
5.	Edema (Dropsy)

Experts

1.	Anand, Inder S: 2 articles (01/2021 - 10/2019)
2.	Martinez, Felipe: 2 articles (01/2021 - 10/2019)
3.	McMurray, John J V: 2 articles (01/2021 - 10/2019)
4.	Pfeffer, Marc A: 2 articles (01/2021 - 10/2019)
5.	Redfield, Margaret M: 2 articles (01/2021 - 10/2019)
6.	Shah, Sanjiv J: 2 articles (01/2021 - 12/2016)
7.	Solomon, Scott D: 2 articles (01/2021 - 10/2019)
8.	Kanoh, Soichiro: 2 articles (12/2012 - 11/2012)
9.	Rubin, Bruce K: 2 articles (12/2012 - 11/2012)
10.	Tanabe, Tsuyoshi: 2 articles (12/2012 - 11/2012)

Drugs and Biologics

Drugs and Important Biological Agents (IBA) related to Paroxysmal Dyspnea:

1.	Morphine (MS Contin)FDA LinkGeneric 01/01/2015 - "There are no studies showing an improvement in objective parameters with the use of morphine in patients with cardiac asthma. " 01/01/2015 - "Morphine should be used with caution in patients with cardiac asthma." 01/01/2015 - "Recent large retrospective cohort studies indicate an increased mortality risk among patients given morphine in the treatment of cardiac asthma, even after correction for confounders. " 01/01/2015 - "According to current Dutch and European guidelines, morphine has a place in the treatment of patients with cardiac asthma. " 01/01/2015 - "[Is morphine indicated in patients with cardiac asthma? "
2.	CilazaprilIBA 01/01/1994 - "In placebo-controlled studies, 1-5 mg of cilazapril once daily for 12 weeks prolonged predose exercise test duration and improved New York Heart Association classification status and signs and symptoms of chronic heart failure, including paroxysmal nocturnal dyspnea. "
3.	Bronchodilator Agents (Bronchodilators)IBA 12/01/2012 - "There appears to be limited effectiveness of classical asthma medications like bronchodilators or corticosteroids in treating cardiac asthma. " 02/01/2009 - "Female sex, steroid use, inhaled bronchodilators, orthopnea, paroxysmal nocturnal dyspnea, and right heart chamber dilatation were significantly associated with increased arm span to height ratio. " 08/01/2008 - "The bases for diagnosis were ranked as follows: 1) recurrent paroxysmal dyspnea or symptoms such as wheezing and cough (86%); 2) detection of wheezing on auscultation (78%); 3) improvement in symptoms or auscultation findings after using bronchodilators (56%); 4) improvement in symptoms or auscultation findings after using inhaled corticosteroids (55%); 5) diagnosis of asthma by another physician (46%); and 6) spirometry findings (31%). "
4.	Adrenal Cortex Hormones (Corticosteroids)IBA 12/01/2012 - "There appears to be limited effectiveness of classical asthma medications like bronchodilators or corticosteroids in treating cardiac asthma. " 08/01/2008 - "The bases for diagnosis were ranked as follows: 1) recurrent paroxysmal dyspnea or symptoms such as wheezing and cough (86%); 2) detection of wheezing on auscultation (78%); 3) improvement in symptoms or auscultation findings after using bronchodilators (56%); 4) improvement in symptoms or auscultation findings after using inhaled corticosteroids (55%); 5) diagnosis of asthma by another physician (46%); and 6) spirometry findings (31%). "
5.	Fosinopril (Monopril)FDA LinkGeneric 01/01/1999 - "At endpoint, more patients improved their NYHA Functional Class and fewer had worsened with fosinopril vs. placebo (p=0.018); fosinopril-treated patients showed improvements in dyspnea (p=0.054), fatigue (p=0.052), edema (p=0.012), and paroxysmal nocturnal dyspnea (p=0.003) vs. the placebo group. "
6.	Dinoprostone (PGE2)FDA Link 01/01/1982 - "Prostaglandin E2 eliminated the attacks of cardiac asthma and angina pectoris, caused by the increase of the left ventricle cavity."
7.	Cholinesterase Inhibitors (Anticholinesterases)IBA 05/01/1984 - "Paroxysmal dyspnea and stridor in a patient with myasthenia were shown to be due to weakness of vocal cord abductors that improved with anticholinesterase therapy. "
8.	Amrinone (Amrinon)FDA Link 07/01/2000 - "Taken together in its positive inotropic and chronotropic effects and anti-inflammatory activity, however, amrinone could be beneficial for treatment of patients suffering from asthma or heart failure with cardiac asthma."
9.	DiureticsIBA 04/01/1948 - "Mercurial diuretics in paroxysmal nocturnal dyspnea." 12/01/1947 - "Mercurial diuretics in paroxysmal nocturnal dyspnea." 12/01/2012 - "Pulmonary edema and pulmonary vascular congestion have been thought to be the primary causes of cardiac asthma but most patients have a poor response to diuretics. " 07/15/2009 - "In this study, public-use copies of the Cardiovascular Health Study (CHS) data sets were used to determine the sensitivity, specificity, and positive and negative predictive values of orthopnea and paroxysmal nocturnal dyspnea (PND), with and without the use of medications used in CHS HF criteria (diuretics plus digoxin or vasodilators), in the diagnosis of prevalent HF and in the assembly of a relatively HF-free population. " 02/10/1980 - "Diuretic administration and vasodilator therapy of cardiac asthma and pulmonary edema (cardiac load reduction) with special reference to SQ 14225 (captopril)]."
10.	Vasodilator Agents (Vasodilators)IBA 01/01/1980 - "[Possibilities for using peripheral vasodilator agents in cardiac asthma and threatened pulmonary edema]." 07/15/2009 - "In this study, public-use copies of the Cardiovascular Health Study (CHS) data sets were used to determine the sensitivity, specificity, and positive and negative predictive values of orthopnea and paroxysmal nocturnal dyspnea (PND), with and without the use of medications used in CHS HF criteria (diuretics plus digoxin or vasodilators), in the diagnosis of prevalent HF and in the assembly of a relatively HF-free population. " 02/10/1980 - "Diuretic administration and vasodilator therapy of cardiac asthma and pulmonary edema (cardiac load reduction) with special reference to SQ 14225 (captopril)]."

Therapies and Procedures

1.	Therapeutics 04/01/1966 - "[Pathogenic therapy of patients with cardiac asthma]." 10/22/1959 - "[The therapy of cardiac asthma]." 08/01/1955 - "Cardiac asthma; pathogenesis and principles of therapy." 07/01/1991 - "shock; -1 (0.2%) non fatal acute myocardial infarction (at the end of the procedure); -2 (0.4%) attacks of cardiac asthma treated successfully with medical therapy. " 01/01/1996 - "In the presence of arrhythmic collapse, cardiac asthma and pulmonary edema it is preferable to correct arrhythmia by electric impulse therapy."
2.	Airway Management 05/01/2016 - "These research priorities covered the following study areas: airway management, asthma, cardiac arrest, pain, patient-family interaction, resource utilization, seizure, sepsis, spinal immobilization, toxicology, trauma, training and competency, and vascular access. "
3.	Nursing Care 04/01/1984 - "[Nursing care of the patient with paroxysmal nocturnal dyspnea]." 03/01/1976 - "[First aid and nursing care of patients with cardiac asthma]."
4.	Renal Dialysis (Hemodialysis) 10/01/2001 - "We report the case of a patient undergoing long-term hemodialysis admitted to hospital for diagnosis of recurrent face and neck edema influenced by dialysis sessions with paroxysmal dyspnea. " 01/01/1981 - "Apart from the good tolerance of the patients with overweight, some other indications for its performance was stressed upon in the paper, namely: cardiac asthma, arterial hypertension difficult to correct by hemodialysis and drugs, osteodystrophia, itching during dialysis and after it, vomiting and headache during dialysis and in-between dialysis periods, pains in the legs. "
5.	Drug Therapy (Chemotherapy) 01/01/2012 - "She presented with new symptoms of exertional dyspnea, paroxysmal nocturnal dyspnea, and orthopnea after a 4th cycle of a bortezomib/dexamethasone-based chemotherapy. " 08/17/2001 - "A 61-year-old man suffering from histologically confirmed amyloidosis associated with coagulation disturbances presented with exercise induced shortness of breath and symptoms of cardiac asthma after four cycles of chemotherapy with melphalan and prednisolone. "