PEMBAGIAN SESAK NAFAS

Dispnea akut : Sesak napas yang berlangsung kurang dari 1bulan

Dispnea kronik : Sesak napas yang berlangsung lebih dari 1bulan
Kategori fisiologik penyakit penyebab dispnea
1. Gangguan mekanik terhadap proses ventilasi
2. Kelemahan pompa napas (respiratory pump)
3. Peningkatan respiratory drive
4. Ventilasi rugi (wasted ventilation)
5. Disfungsi psikologik
Gangguan mekanik terhadap proses ventilasi
Obstruksi aliran napas (sentral atau perifer)
Asma, PPOK
Tumor endobronkial
Stenosis trakea / laring
Gangguan pengembangan paru (stiff lung)
Interstitial fibrosis
Gagal jantung kiri
Tumor linfangitik
Gangguan pengembangan dinding dada atau diafragma
Penebalan pleura, kifoskoliosis, obesiti, masa intraabdomen, Kehamilan

Kelemahan pompa napas (respiratory pump)

Absolut
Riwayat poliomielitis

Penyakit

neuromuskular

(Sindrom

Guillain

Barre,

hipertiroidisme)
Relatif
Hiperinflasi
Efusi pleura
Pneumotoraks
Peningkatan respiratory drive
Hipoksemia
Asidosis metabolik
Penyakit ginjal
Anemia, hemoglobinopati
Penurunan curah jantung
Stimulasi reseptor intrapulmoner
Infiltrative lung disease, hipertensi pulmoner, edem paru
Ventilasi rugi (wasted ventilation)
Destruksi kapiler
Misal pada emfisema, interstitial lung disease
Obstruksi pembuluh darah besar
Misal emboli paru, vaskulitis pulmoner

muscular

dystrophy,

SLE,

Disfungsi psikologik
Somatisasi
Ansietas
Depresi
Diagnosis banding dispnea akut
Cardiac: congestive heart failure, coronary artery disease, arrhythmia,pericarditis, acute
myocardial infarction, anemia
Pulmonary: chronic obstructive pulmonary disease, asthma, pneumonia,pneumothorax,
pulmonary embolism, pleural effusion,metastatic disease, pulmonary edema, gastroesophageal
reflux disease with aspiration, restrictive lung disease
Psychogenic: panic attacks, hyperventilation, pain, anxiety
Upper airway obstruction: epiglottitis, foreign body, croup, Epstein-Barr virus
Endocrine: metabolic acidosis, medications
Central: neuromuscular disorders, pain, aspirin overdose
Pediatric: bronchiolitis, croup, epiglottitis, foreign body aspiration, myocarditis

Diagnosis banding dispnea kronik

Cardiac
Congestive heart failure
Coronary artery disease
Cardiac arrhythmias
Pericardial disease
Valvular heart disease
Pulmonary
Chronic obstructive pulmonary disease
Asthma

 Interstitial lung disease

Pleural effusion
Malignancy (primary or metastatic)
Bronchiectasis
Noncardiac or nonpulmonary (less common)
Thromboembolic disease
Psychogenic causes (GAD, PTSD, panic
disorders)
Deconditioning
Pulmonary hypertension
Obesity (massive)
Severe anemia
Gastroesophageal reflux disease
Metabolic conditions (acidosis, uremia)
Liver cirrhosis
Thyroid disease
Neuromuscular disorders (myasthenia gravis,
amyotrophic lateral sclerosis)
Chest wall deformities (kyphoscoliosis)
Upper airway obstruction (laryngeal disease,tracheal stenosis)