- Reasons of a syndrome of Cheyna-Stokes
- Symptoms of a syndrome of Cheyna-Stokes
- Treatment of a syndrome of Cheyna-Stokes
Cheyn's breath — Stokes, periodic breathing — breath at which the superficial and rare respiratory movements gradually become frequent and go deep and, having reached a maximum on the fifth — the seventh breath, are weakened and urezhatsya again then there comes the pause. Then the cycle of breath is repeated in the same sequence and passes into the next respiratory pause. The name is given on names of physicians John Cheyn and William Stokes in whose works of the beginning of the 19th century this symptom was for the first time described.
Reasons of a syndrome of Cheyna-Stokes:
I take place the cyclic, arriving and decreasing, fluctuating patterns of episodes of TsSA alternating hyperpnea episodes (breath like Cheyn-Stokes). Normal at adults the Ras02 level increases in a dream approximately on 7 mm of mercury. There is a hypothesis that decrease in sokratitelny function of heart leads to lengthening of time of circulation with a central delay of the response to such fluctuation of the Ras02 level in a dream. It also leads to emergence of breath like Cheyn-Stokes. In most cases, however, it is not possible to find the specific anatomic substrate allowing to explain clearly this phenomenon.
Symptoms of a syndrome of Cheyna-Stokes:
Anamnesis and objective research of breath of Cheyn-Stokes.
Most of experts consider that diagnosis of DSChS in a dream requires existence at the patient of the expressed heart failure or disturbance of cerebral circulation. Such patients can complain of an insomniya with disturbance of a normal current of a dream. At expressiveness of primary disease breath like Cheyn-Stokes can be observed also in a condition of wakefulness. Careful inspection for the purpose of identification of damage of a brainstem and chronic heart failure is necessary. Party of Free Citizens. There have to be, at least, three clear periods of cyclic breath on the increase decrease type, everyone lasting more than 10 seconds. Frustration is considered expressed when the separate periods of breath like Cheyn-Stokes proceed 10 and more minutes in a row. About severity it is possible to judge by the breath duration relation like Cheyn-Stokes by the general time of a dream. Most often breath like Cheyn-Stokes is observed in a phase of a slow dream. Parallel fluctuations of a respiration rate, ChSS and ABP are noted. Awakenings happen most often in the period of the maximum hyperpnea. Breath like Cheyn-Stokes in a condition of wakefulness is more significant risk factor of death, than breath like Cheyn-Stokes only in a dream.
Differential diagnosis of breath of Cheyn-Stokes.
DSChS can exist along with the WASP. Characteristic clinical signs of heart failure or disturbance of cerebral circulation, and also the periods of cyclic breath on the increase decrease type allow to differentiate DSChS from the WASP. Metabolic disturbances, for example, at a renal failure, can be followed by emergence of breath of Cheyn-Stokes. Clinical manifestations and the anamnesis help to differentiate DSChS from the periodic breathing induced by highlands in a dream.
Other researches at Cheyn-Stokes's breath.
Ras02 an arterial blood, measured at the awake patient in lying situation, it is frequent below norm or is on the lower bound of norm. At a research of functions of lungs the ventilating answer to C02 is raised. Except a X-ray analysis of a thorax, an ECG and definition of cordial isoenzymes, researches of cordial function since Cheyn-Stokes's breath is registered approximately at a half of all patients with heart failure and fraction of emission of a left ventricle lower than 40% can be informative. MRT of bark and a trunk of a brain it is shown in the presence of the anamnesis and clinical signs of a craniocereberal injury.
Treatment of a syndrome of Cheyna-Stokes:
Treatment of a basic disease is carried out.