![]() ![]() ![]() For example, "three-pillow" orthopnea is worse than "two-pillow" orthopnea, because you have less tolerance for lying flat. To gauge the severity of this symptom, doctors often ask people how many pillows they need to lie on to avoid feeling short of breath in bed. The severity of this symptom usually depends on how flat you are lying-the flatter you lie, the more you feel short of breath. The medical term for this symptom is orthopnea (say "or-THAWP-nee-uh"). People with more severe heart failure may experience shortness of breath when they lie down. But people with more severe heart failure may have shortness of breath with minimal exertion. When heart failure develops gradually, your shortness of breath also may develop gradually, which can make it hard to notice. The medical term for this symptom is dyspnea (say "DISP-nee-uh"). If your shortness of breath isn't severe, you may notice it only when you are exerting yourself, and sometimes only during more intense exertion. ![]() Shortness of breath from exertion or exercise. It gets worse when you lie flat, and it may wake you up at night.People with heart failure experience shortness of breath in many different ways. Your doctor can help you determine why you have been feeling short of breath. While shortness of breath is the most common symptom of heart failure, it may be difficult or impossible to distinguish it from shortness of breath caused by other health problems such as emphysema or severe anemia. However, nearly 99% (negative predictive value) of those with neither symptom nor using HF medications also did not have HF, which may be useful as a simple and inexpensive tool in assembling relatively HF-free cohorts for prospective population studies of incident HF.If you have heart failure, symptoms start to happen when your heart cannot pump enough blood to the rest of your body. ![]() In conclusion, only <20% of those with either orthopnea or PND had definite HF, which limits their usefulness in the diagnosis of prevalent HF in the community. The sensitivity, specificity, and positive and negative predictive values for either orthopnea or PND were 52% (95% confidence interval 46% to 58%), 83% (95% CI 82% to 84%), 13% (95% CI 11% to 15%), and 97% (95% CI 97% to 98%), respectively, and those for either orthopnea or PND or the use of HF medications were 77% (95% CI 72% to 82%), 77% (95% CI 76% to 79%), 14% (95% CI 13% to 16%), and 99% (95% CI 98% to 99%), respectively. Definite HF was centrally adjudicated in 272 participants. Of the 5,771 community-dwelling older adults aged > or =65 years, 803 had orthopnea, 660 had PND, 1,075 had either symptom, 388 had both symptoms, 547 were using HF medications, and 4,315 had neither symptom and were not using HF medications. 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. Prospective population studies of incident heart failure (HF) are often limited by difficulties in assembling HF-free cohorts. ![]()
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