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Ferguson, Jill. "How Paroxysmal Nocturnal Dyspnea Works." 20 March 2008. HowStuffWorks.com. <http://health.howstuffworks.com/paroxysmal-nocturnal-dyspnea.htm> 17 May 2008.
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Causes of Paroxysmal Nocturnal Dyspnea
Paroxysmal nocturnal dyspnea and orthopnea have similar causes. One of the causes of orthopnea is pulmonary congestion (excessive or abnormal accumulation of blood in the lungs) when a patient lies down and blood moves from the lower part of the body to the lungs. In normal individuals this has little effect, but in heart failure patients, the diseased left side of the heart can't pump out the additional volume. So blood backs up in the vessels of the lungs, causing shortness of breath.
Also, lung circulation in patients with congestive heart failure may already be overloaded. This condition may be worsened by fluid overload, excess fluid that accumulates in the lower part of the body during the day and moves into the lungs when the patient lies down. Lung congestion decreases when the patient raises his upper body.
In paroxysmal nocturnal dyspnea, increasing amounts of fluid enter the lungs during sleep and fill the small, air-filled sacs in the lungs where oxygen is absorbed from the atmosphere. The failing left side of the heart is suddenly unable to match the output of a more normally functioning right side, resulting in congestion in the lungs, coughing and wheezing, and sometimes the production of sputum (mucus and other matter, which may be bloody). We don't know why paroxysmal nocturnal dyspnea occurs so suddenly in patients with left heart failure.
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Please copy/paste the following text to properly cite this How Stuff Works article:
Ferguson, Jill. "How Paroxysmal Nocturnal Dyspnea Works." 20 March 2008. HowStuffWorks.com. <http://health.howstuffworks.com/paroxysmal-nocturnal-dyspnea.htm> 17 May 2008.
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Abdominal Bloating Abdominal Fullness Prematurely Afte... Abdominal Lumps Abdominal Mass Abdominal Pain Abdominal Rigidity Abdominal Sounds Abdominal Swelling Abnormal Posturing Abnormal Tooth Shape Abnormally Dark Or Light Skin Absent Menstruation Absent Thirst Agitation Ambiguous Genitalia Ankle Pain Appetite Decrease Appetite Increase Apraxia Arachnodactyly Armpit Lump Autistic Behavior Babinski's Reflex Bed Wetting Belching Binge Eating Blackheads Bleeding Gums Bleeding Into The Skin Blindness Blockage Of Leg Arteries Blood In The Semen Blood in Urine Bloody Or Tarry Stools Bone Pain Or Tenderness Bounding Pulse Bowel Incontinence Breast Lump Breast Pain Breath Odor Breath Sounds Breathing - Slowed Or Stopped Breathing Difficulty Breathing Difficulty When Lying Dow... Breathing That Sounds Abnormal Broad Nasal Bridge Bulging Fontanelles Bullae Chemosis Chest Pain Chills Clammy Skin Claw Foot Claw Hand Cloudy Cornea Clubbing Of The Fingers Or Toes Cold Intolerance Coloboma Of The Iris Comedones Confusion Constipation Contracture Deformity Coughing Coughing Up Blood Crying Excessively in Infants Cyst Decerebrate Posture Decorticate Posture Decreased Consciousness Decreased Urine Output Delayed Growth Delayed or Absent Tooth Formation Depression Diarrhea Difficulty with Urination Dizziness Drooling Drowsiness Dry Eyes Dry Hair Dry Skin Ear Discharge Earache Earlobe Creases Elbow Pain Epicanthal Folds Erection Problems Erosion Excessive Or Unwanted Hair In Women Excessive Thirst Excessive Urination Excessive Urination at Night Excessively Large Fontanelles Eye Burning, Itching and Discharge Eye Pain Eye Redness Eye Slant Eyelid Drooping Eyes That Bulge Face Pain Facial Paralysis Facial Swelling Fainting Fatigue Female Sexual Dysfunction Fever Finger Pain Fingers That Change Color Flank Pain Floating Stools Focal Neurological Deficits Foot Pain Foot, Leg, And Ankle Swelling Foul Smelling Stools Frequent Or Urgent Urination Frontal Bossing Gas (Flatulence) Gastrointestinal Bleeding Genital Sores (Female) Genital Sores (Male) Groin Lumps Groin Pain Gynecomastia Hair Loss Hallucinations Hand Or Foot Spasms Hand Tremors Headache Hearing Loss Heart Murmurs And Other Sounds Heart Palpitations Heartburn Heat Intolerance Heavy, Prolonged, or Irregular Mens... 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Barrett’s Esophagus Bartholin’s Abscess Bartter Syndrome Basal Cell Carcinoma Basal Cell Nevus Syndrome Basal Ganglia Dysfunction Bassen-Kornzweig Syndrome Bathing Trunk Nevus Becker's Muscular Dystrophy Beckwith-Wiedemann Syndrome Bedwetting Bell's Palsy Benign Ear Cyst Or Tumor Benign Positional Vertigo Beriberi Bezoar Bilateral Hydronephrosis Bile Duct Obstruction Biliary Atresia Biliary Stricture Bipolar Disorder Birth-acquired Herpes Birthmarks - Pigmented Birthmarks - Red Bladder Cancer Bladder Outlet Obstruction Bladder Stones Blastomycosis Blastomycosis Skin Lesion Bleeding Disorders Bleeding Esophageal Varices Blepharitis Blind Loop Syndrome Blocked Tear Duct Blood Clots Blount's Disease Body Lice Bone Tumors Borderline Personality Disorder Botulism Bowlegs Brachial Palsy In Newborns Brachial Plexopathy Brain Abscess Brain Herniation Brain Tumor - Adults Brain Tumor - Children Branchial Cleft Cyst Breast Cancer Breast Infection Breast Milk Jaundice Breath Holding Spell Brief Reactive Psychosis Bronchial Adenoma Bronchiectasis Bronchiolitis Bronchitis Bronchopulmonary Dysplasia Brucellosis Bruxism Bulimia Bullous Pemphigoid Bunions Burkitt Lymphoma Bursitis Byssinosis Campylobacter Enteritis Canavan Disease Cancer Cancer - Penis Cancer - Renal Pelvis Or Ureter Cancer - Throat Or Larynx Cancer - Vulva Candida Esophagitis Canker Sores Caplan Syndrome Caput Succedaneum Carbunculosis Carcinoid Syndrome Cardiac Amyloidosis Cardiac Tamponade Cardiogenic Shock Cardiomyopathy Carpal Tunnel Syndrome Cat Scratch Disease Cataract Catheter-associated UTI Cavernous Sinus Thrombosis Celiac Disease - Sprue Cellulitis Central Pontine Myelinolysis Central Serous Choroidopathy Central Sleep Apnea Cerebral Hypoxia Cerebral Palsy Cervical Cancer Cervical Dysplasia Cervical Polyps Cervical Spondylosis Cervicitis Chagas Disease Chalazion Chancroid Charcot-Marie-Tooth Disease (heredi... 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