n.

起坐呼吸

身体を横にしたとき生じる呼吸困難。

WordNet

form of dyspnea in which the person can breathe comfortably only when standing or sitting erect; associated with asthma and emphysema and angina pectoris

Wikipedia preview

出典(authority):フリー百科事典『ウィキペディア（Wikipedia）』「2016/01/31 11:15:52」(JST)

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[Wiki en表示]

Orthopnea or orthopnoea (Greek from ortho, straight + pnoia, breath) is shortness of breath (dyspnea) which occurs when lying flat,^[1] causing the person to have to sleep propped up in bed or sitting in a chair. It is the opposite of platypnea. It is commonly seen as a late manifestation of heart failure, resulting from fluid redistribution into the central circulation, causing an increase in pulmonary capillary pressure. It is also seen in cases of abdominal obesity or pulmonary disease.^[2]

CausesEdit

Orthopnea is due to increased distribution of blood to the pulmonary circulation while recumbent,^[3] but usually can be attributed to a more fundamental cause.

Orthopnea is often a symptom of left ventricular heart failure and/or pulmonary edema.^[4]^[5] It can also occur in those with asthma and chronic bronchitis, as well as those with sleep apnea or panic disorder.^{[citation needed]} It is also associated with polycystic liver disease.^{[citation needed]} From a neuromuscular perspective, orthopnea is a sign of severe diaphragmatic weakness. Under such circumstances, patients may describe shortness of breath when they bend over (e.g. when tying shoelaces).

ReferencesEdit

^ "orthopnea" at Dorland's Medical Dictionary
^ Anthony Fauci, Eugene Braunwald, Dennis Kasper, Stephen Hauser, Dan Longo, J. Jameson, Joseph Loscalzo, (2008). Harrison's Principles of Internal Medicine, 17th ed. McGraw-Hill. ISBN 9780071466332. p.1446
^ "Dyspnea, Orthopnea, and Paroxysmal Nocturnal Dyspnea -- Clinical Methods -- NCBI Bookshelf". Retrieved 2009-03-14.
^ Torchio R, Gulotta C, Greco-Lucchina P, et al. (August 2006). "Orthopnea and tidal expiratory flow limitation in chronic heart failure". Chest 130 (2): 472–9. doi:10.1378/chest.130.2.472. PMID 16899847.
^ Walker, H. Kenneth; Vaskar Mukerji (1990). Clinical Methods. Butterworths. ISBN 0-407-02853-6. Retrieved 2009-01-16.

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UpToDate Contents

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1. 心不全が疑われる患者の評価 evaluation of the patient with suspected heart failure
2. 両側性横隔膜麻痺の原因および診断 causes and diagnosis of bilateral diaphragmatic paralysis
3. 中枢性睡眠時無呼吸：危険因子、臨床症状、および診断 central sleep apnea risk factors clinical presentation and diagnosis
4. 筋強直性ジストロフィー：病因、臨床的特徴、および診断 myotonic dystrophy etiology clinical features and diagnosis
5. 成人における一側性横隔膜麻痺および横隔膜挙上の原因および診断 causes and diagnosis of unilateral diaphragmatic paralysis and eventration in adults

English Journal

A case of catastrophic antiphospholipid syndrome: first report with advanced cardiac imaging using MRI.

Rosenbaum AN1, Anavekar NS2, Ernste FC3, Mankad SV2, Le RJ2, Manocha KK4, Barsness GW2.
Lupus.Lupus.2015 Oct;24(12):1338-41. doi: 10.1177/0961203315587960. Epub 2015 May 26.
This present case pertains to a 48-year-old woman with a history of antiphospholipid syndrome, who presented with progressive fatigue, generalized weakness, and orthopnea acutely. She had a prior diagnosis of antiphospholipid syndrome with recurrent deep vein thromboses (DVTs) and repeated demonstra
PMID 26014099

Clinical Differentiation of Respiratory Nursing Diagnoses among Children with Acute Respiratory Infection.

Pascoal LM1, Lopes MV2, da Silva VM3, Chaves DB3, Beltrão BA3, Nunes MM3, de Moura KK3.
Journal of pediatric nursing.J Pediatr Nurs.2015 Sep 4. pii: S0882-5963(15)00243-2. doi: 10.1016/j.pedn.2015.08.002. [Epub ahead of print]
The aim of this study was to identify the defining characteristics that allow clinical differentiation of the nursing diagnoses, ineffective breathing pattern (IBP), ineffective airway clearance (IAC), and impaired gas exchange (IGE). A secondary analysis with a cohort design was developed from 1128
PMID 26346618

Effect of patient positioning on toe pressure measurement using noninvasive vascular testing.

Sansosti LE1, Berger MD1, Gerrity MA2, Kelly P3, Meyr AJ4.
British journal of community nursing.Br J Community Nurs.2015 Sep;20 Suppl 9:S12-6. doi: 10.12968/bjcn.2015.20.Sup9.S12.
OBJECTIVE: Interpretation of digital pressure in the assessment of healing potential for diabetic foot disease has become common because of the potential for false elevation with the ankle-brachial index. However, the specific testing protocol for segmental Doppler examinations and photoplethysmogra
PMID 26322400

Japanese Journal

成長ホルモン産生下垂体腫瘍摘出後,心機能の正常化したacromegalic cardiomyopathyの1例

内田一好,田口芳雄,榊原陽太郎,岡田正昭,星晶子,和久井大輔
脳神経外科ジャーナル 21(1), 39-43, 2012-01-20
GH産生下垂体腫瘍摘出後,心機能が速やかに改善した症例を経験した.症例は54歳男性,呼吸困難を主訴に来院し,拡張型心筋症と診断された.先端巨大症様顔貌の精査で,GH高値と下垂体腫瘍が検出され,acromegalic cardiomyopathyと診断された.その後,経蝶形骨洞腫瘍摘出術を施行した.術直後から自覚症状は改善し,GH,IGF-1も低下した.術後5ヵ月で心機能はほぼ正常化した.本症例のよ …
NAID 110009328122

心膜液を伴う強皮症腎クリーゼの1例

本田謙次郎,大瀬貴元,須藤裕嗣,上田浩平,鮎澤信宏,正路久美,藤乗嗣泰,関常司,藤田敏郎
日本透析医学会雑誌 = Journal of Japanese Society for Dialysis Therapy 44(5), 455-461, 2011-05-28
症例は62歳，女性．生来健康だったが3年前から両手指ソーセージ様腫脹，指尖潰瘍とRaynaud症状が出現，口周囲皺の減少もみられ，1年前から労作時呼吸困難も出現した．近医で漢方薬を処方されたが症状に改善はみられなかった．起座呼吸を主訴に前医に入院，乳頭浮腫を伴う高血圧，大量心膜液，うっ血性心不全，肺線維症，破砕赤血球像と腎機能障害を認めた．入院後は降圧治療を行い血圧は150/80 mmHg程度まで …
NAID 10029406882

A Case of Cardiomyopathy with Apparent Interventricular Dyssynchrony Due to Severe Transseptal Conduction Disturbance

Yaegashi Takanori,Furusho Hiroshi,Chikata Akio,Usui Soichiro,Kaneko Shuichi,Yamagishi Masakazu,Takamura Masayuki
Journal of Arrhythmia 27(Supplement), PJ3_031-PJ3_031, 2011
… The patient had lapsed into orthopnea since January, 2011. …
NAID 130002130313

A Sinus of Valsalva - Right Atrium Fistula without Aneurysm Formation

Kanzaki Yumiko,Terasaki Fumio,Fuji Shigeo,Kashiyama Tomokazu,Kaibe Shoji,Doi Yasuji,Kitaura Yasushi
Internal Medicine 49(8), 749-751, 2010
… A 61-year-old man was admitted to the hospital because of orthopnea and was diagnosed with heart failure with a continuous heart murmur. …
NAID 130000251860

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リンク元

「起坐呼吸」

Orthopnea
Classification and external resources
Specialty	Cardiology
ICD-10	R06.0
ICD-9-CM	786.02
	[edit on Wikidata]

　　[★]

ortho
英: orthopnea
同: 起座呼吸(医学用語としては起坐呼吸が正しい)
関: 肺うっ血、肺水腫

[show details]

起坐呼吸 orthopnea : 95 件
起座呼吸 orthopnea : 約 8,640 件

起坐呼吸 orthopnea : 95 件
起座呼吸 orthopnea : 約 8,640 件

病態生理

臥位では下肢の血液が肺に再分布してうっ血を生じ、以下のことが起こる。その結果、症状を和らげるために起坐呼吸をおこなう。

1. 間質に漏出液が蓄積　→　1-1,2により吸気仕事量が増大する

1-1. 肺コンプライアンスが低下する
1-2. 気道が狭小化し、気道抵抗増大

2. 漏出液が間質から肺胞腔に移動し、ガス交換を妨げる

原因疾患

左心不全(僧帽弁狭窄症、うっ血性心不全)　→　臥位により肺血流の増加　→　症状悪化
気管支喘息　→　呼吸仕事量が増大

[1] "orthopnea" at Dorland's Medical Dictionary

[2] Anthony Fauci, Eugene Braunwald, Dennis Kasper, Stephen Hauser, Dan Longo, J. Jameson, Joseph Loscalzo, (2008). Harrison's Principles of Internal Medicine, 17th ed. McGraw-Hill. ISBN 9780071466332. p.1446

[urlDyspnea.2C_Orthopnea.2C_and_Paroxysmal_Nocturnal_Dyspnea_--_Clinical_Methods_--_NCBI_Bookshelf-3] "Dyspnea, Orthopnea, and Paroxysmal Nocturnal Dyspnea -- Clinical Methods -- NCBI Bookshelf". Retrieved 2009-03-14.

[pmid16899847-4] Torchio R, Gulotta C, Greco-Lucchina P, et al. (August 2006). "Orthopnea and tidal expiratory flow limitation in chronic heart failure". Chest 130 (2): 472–9. doi:10.1378/chest.130.2.472. PMID 16899847.

[clinicalmethods-5] Walker, H. Kenneth; Vaskar Mukerji (1990). Clinical Methods. Butterworths. ISBN 0-407-02853-6. Retrieved 2009-01-16.

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案内

orthopnea