Multidimensional approach to dyspnea.

PURPOSE OF REVIEW

This review focuses on sensory-perceptual and affective/emotional domains of dyspnea.

RECENT FINDINGS

Recent studies have underscored the multidimensional aspect of dyspnea, which comprises three major dimensions: the sensory-perceptual domain, the affective distress, and the symptom impact or burden. Sensory-perceptual dimension includes ratings of dyspnea intensity and its quality, that is, 'how breathing feels like.' Affective distress addresses the question of 'how distressing breathing is' and focuses on the perception of immediate unpleasantness or the cognitive evaluative response about the potential consequence of what is perceived. Symptom impact evaluates how dyspnea impacts on functional ability/disability, health status, and/or quality of life.

SUMMARY

Dyspnea is a debilitating symptom and the major reason for seeking medical attention in patients with cardiorespiratory diseases. Dyspnea predicts morbidity, quality of life, and mortality in several different conditions. Notwithstanding sometimes patients neglect to report dyspnea to their clinician because they feel it is not sufficiently relevant to be documented. The relationship between what the patients feel, how they express themselves about the disease, and how caregivers interpret their complaints is complex and not easy to decipher. It is important to correctly recognize dyspnea, and optimize and individualize its clinical management.