Recognizing Symptoms of Hyperventilation Syndrome

scared woman on plane
Hyperventilation goes with feelings of panic.. Westend61 / Getty Images

Hyperventilation syndrome is a nonmedical cause of shortness of breath. It is very scary, but not life-threatening. It can be hard to tell hyperventilation syndrome apart from other causes of shortness of breath. If there is any doubt about the cause of difficulty breathing, call 911 immediately.

Read How to Treat Hyperventilation Syndrome to learn the steps for helping a patient overcome the feelings that cause hyperventilation syndrome.

Causes of Hyperventilation Syndrome

The term hyperventilation syndrome is a shortened version of the more descriptive psychogenic hyperventilation syndrome, which indicates a psychosomatic cause for breathing too deep and/or too fast. Basically, that means there is some sort of behavioral or emotional reason for the hyperventilation. In most cases, hyperventilation goes hand-in-hand with anxiety or panic disorders. Many of the symptoms of hyperventilation syndrome appear during what are commonly called panic attacks.

There are other, more serious medical conditions that may lead to hyperventilation. The most serious is related to an increase of pressure inside the skull (intracranial pressure), which can happen from a traumatic brain injury or from a stroke. The increased pressure pushes the brain through the foramen magnum, the opening in the base of the skull where the spinal cord exits.

This is called herniation of the brain and leads to neurogenic hyperventilation syndrome, an involuntary reaction of the respiratory centers in the brain to increases in pressure.

For the purposes of this article, the term hyperventilation syndrome refers to conditions stemming from behavioral causes.

Recognizing Hyperventilation Syndrome

If a patient with rapid, shallow breathing has the ability to become more calm and slow his or her breathing, it may be hyperventilation syndrome. A behavioral cause of hyperventilation can be overcome, a medical cause of rapid breathing probably cannot. Working with the patient to slow his breathing often distinguishes the condition from other causes of shortness of breath as well as treats it.

Never assume a patient is suffering from hyperventilation syndrome. Always look for other causes of shortness of breath first. It's important to note that hyperventilation patients must be conscious and able to communicate. Unconscious or unresponsive victims are likely not suffering from hyperventilation syndrome.

Hyperventilation Symptoms: The Nijmegen Questionnaire

Developed to screen patients complaining of shortness of breath for possible hyperventilation syndrome, the Nijmegen questionnaire identifies several signs and symptoms of hyperventilation syndrome.

Correctly using this screening tool requires a clinical background, especially since many of the screening questions could be symptoms of much more serious medical conditions.

Of the hyperventilation syndrome symptoms and signs listed in the Nijmegen questionnaire, there are several that are distinctly related to hyperventilation syndrome. These signs and symptoms are strong indicators of hyperventilation syndrome, especially if the patient has several of them:

  • Tense feeling
  • Dizziness
  • Fast or deep breathing
  • Tingling in fingers and hands
  • Stiffness or cramps in fingers and hands
  • Tightness around the mouth
  • Cold hands or feet
  • Palpitations in the chest
  • Anxiety

Despite their relationship to hyperventilation syndrome, each of these signs and symptoms could also be related to other medical conditions. Always assume the worst possible scenario first, then proceed to less serious conditions, in order to identify the cause of shortness of breath.

References

Gardner, W. The pathophysiology of hyperventilation disorders. Chest 1996;109:516-34

Han J.N., K. Stegen, K. Simkens, M. Cauberghs, R. Schepers, O. Van den Bergh, J. Clement, and K.P. Van de Woestijne. Unsteadiness of breathing in patients with hyperventilation syndrome and anxiety disorders. Eur Respir J. 1997;10:167–176

van Dixhoorn, J and Duivenvoorden, HJ. Efficacy of Nijmegen Questionnaire in recognition of the hyperventilation syndrome. J Psychosom Res. 1985;29(2):199-206

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