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Spasm of the breathing muscles as a reason for dyspnea?
- Question
- Hello,
I am a general practitioner and I am treating a 20 year-old CF patient, who have been clinically quite inconspicious up to now. Additionally he is under that care of a CF center and is regularly provided with antibiotics in case of exacerbations, under monitoring of the CRP, there.
Today he came into my office, with a severe dys- and tachypnea and mentioned as a reason that "the breathing muscles and the muscles of the thorax would cramp painfully" which would be the reason that hinders him from breathing freely. After a pulmonary infection has been excluded by the colleagues, I ask myself if this could be a hyperventilation tetany that affects the breathing muscles and worsens the dyspnea in an attack at that.
Does an involvement of the muscles exist in CF?
Many thanks for your thoughts. - Answer
- Dear colleague,
I am always very pleased if there is a cooperation between the general practitioners and the CF centers, which is obviously the case here. That leads for sure to an improved care of the CF patients. Many thanks to you for that! If you have questions, you are invited to phone to the CF out-patient departement for adults in Frankfurt/Main, Germany, at any time.
Now to your question: theoretically a hyperventilation tetany would be quite possible in CF, in everyday life it is however extremely seldom. A regularly performed lung function test and blood gas analysis (standard investigation at routine care appointments in a CF center) and control blood gas analysis especially also during the dyspnea is able to describe the actual condition, can describe and specify a possibly present respiratory insufficiency, can prove or exclude a hyperventilation. Spasmodic pain of the thorax can occur in adults with CF. This can be interpreted as a consequence of a muscular overlaod due to the chronic cough. In this case breathing excercise, physiotherapy are helpful, in single cases pain medication is necessary. An involvement of the muscles in CF does not exist.
I hope to have helped you with this answer a bit.
Yours sincerely,
Dr. Christina Smaczny - 06.04.2009
