Edit concept Create issue ticket

Acute Hyperventilation


  • Misattribution of the presenting complaints to a cardiac or other life-threatening disorder was reported in 20 patients (87%) and was the main reason for their presentation to the hospital.[ncbi.nlm.nih.gov]
  • The final chapter presents clinical cases to illuminate useful strategies for exercise testing and interpretation. Useful appendices offer laboratory forms, algorithms and calculations, as well as answers to FAQs.[books.google.com]
  • Additionally, you may go back to previous EM:RAP episodes and redeem CME (any episode Jan 2015 to the present, 6 hours per month). On EM:RAP we try to make make the process simple and the question sets are quite reasonable.[emrap.org]
  • Patients with chronic HVS present with similar symptoms, including recurrent chest pain, dyspnea, and neurologic deficits, and usually have had many similar presentations in the past.[emedicine.medscape.com]
  • All patients presenting to the ED with the primary diagnosis of primary hyperventilation during the study period were eligible for study inclusion.[journals.plos.org]
  • Hyperventilation syndrome is anxiety-related dyspnea and tachypnea often accompanied by systemic symptoms. Hyperventilation syndrome most commonly occurs among young women but can affect either sex at any age.[merckmanuals.com]
  • The symptoms of acute hyperventilation are mainly caused by the hypocalcemia . 4 Symptoms Tachypnea Muscle spasms Paresthesia Dizziness Anxiety Spasms of the muscles of the lower arm and hands ( hyperventilation tetany ) can lead to the characteristic[flexikon.doccheck.com]
  • Acute hyperventilation with obvious tachypnea accounts for about 1% of all cases of hyperventilation ( Lum 1975 ).[medlink.com]
  • Acute hyperventilation Patients often present dramatically, with agitation, hyperpnea and tachypnea, chest pain, dyspnea, wheezing, dizziness, palpitations, tetanic cramps (eg, carpopedal spasm), paresthesias, generalized weakness, and syncope .[emedicine.medscape.com]
  • At the onset of an acute asthma attack, patients commonly experience difficulty breathing and: Common signs and symptoms of acute hyperventilation syndrome include: tachypnea and tingling in the extremities.[quizlet.com]
  • Abstract The hyperventilation syndrome is generally considered an acute, transitory episode characterized by gross hyperpnea and culminating in frank tetany.[annals.org]
  • Hyperpnea or hyperventilation • Hyperpnea or hyperpnoea is increased depth of breathing when required to meet metabolic demand of body tissues, such as during or following exercise, or when the body lacks oxygen (hypoxia), for instance in high altitude[slideshare.net]
  • Acute hyperventilation Patients often present dramatically, with agitation, hyperpnea and tachypnea, chest pain, dyspnea, wheezing, dizziness, palpitations, tetanic cramps (eg, carpopedal spasm), paresthesias, generalized weakness, and syncope .[emedicine.medscape.com]
  • R29.0 ICD-10-CM Diagnosis Code R29.0 Tetany 2016 2017 2018 2019 Billable/Specific Code Applicable To Carpopedal spasm Type 1 Excludes hysterical tetany ( F44.5 ) neonatal tetany ( P71.3 ) parathyroid tetany ( E20.9 ) post-thyroidectomy tetany ( E89.2 ) hyperpnea[icd10data.com]
Carpopedal Spasm
  • The diagnosis of HVS should be considered in young patients without cardiac risk factors who present with chest pain, particularly if the pain is associated with paresthesias and carpopedal spasm.[emedicine.medscape.com]
  • Hyperventilation syndrome related to anxiety can cause alkalosis severe enough to cause carpopedal spasm. A mild fairly well compensated respiratory alkalosis is the usual finding in pregnancy .[anaesthesiamcq.com]
  • Carpopedal spasm occurs when acute hypocarbia causes reduced ionized calcium and phosphate levels, resulting in involuntary contraction of the feet or (more commonly) the hands . 25.[slideshare.net]
  • Before neuraxial analgesia had been established, however, and after a period of hyperventilation, the patient was found lying supine with both arms and legs extended, and both wrists in extreme flexion (carpopedal spasm), looking upwards and breathing[academic.oup.com]
  • spasm Type 1 Excludes hysterical tetany ( F44.5 ) neonatal tetany ( P71.3 ) parathyroid tetany ( E20.9 ) post-thyroidectomy tetany ( E89.2 ) hyperpnea R06.4 hyperventilation R06.4 - see also Hyperventilation ICD-10-CM Codes Adjacent To R06.4 R06 Abnormalities[icd10data.com]
Muscle Twitch
  • Acute secondary hypocalcemia can result in carpopedal spasm, muscle twitching, a prolonged QT interval, and positive Chvostek and Trousseau signs. Hypokalemia tends to be less pronounced than hypocalcemia but can produce generalized weakness.[emedicine.medscape.com]
  • twitching Many different factors can cause chest symptoms with hyperventilation syndrome.[emedicinehealth.com]
  • , twitching and cramps, tension and panicky feelings, depression and anxiety.[familydoctor.co.nz]
  • Muscle twitching, spasms, and weakness may be noted. Seizures, irregular heart beats, and tetany (muscle spasms so severe that the muscle locks in a rigid position) can result from severe respiratory alkalosis.[medical-dictionary.thefreedictionary.com]
  • . • Acute secondary hypocalcemia can result in carpopedal spasm, muscle twitching, a prolonged QT interval, and positive Chvostek and Trousseau signs. • Hypokalemia tends to be less pronounced than hypocalcemia but can produce generalized weakness. •[slideshare.net]
Chvostek Sign
  • Chvostek's sign is also due to hypocalcaemia. Flick behind the ear, just in front of the mastoid bone where the facial nerve emerges. The hypersensitive facial nerve makes the muscles of the face twitch.[patient.info]
  • […] cuff . 30. • Chvostek’s sign is neither sensitive nor specific for hypocalcemia, since it is absent in about one third of patients with hypocalcemia and is present in approximately 10% of persons with normal calcium levels. • Trousseau’s sign is more[slideshare.net]
Leg Cramp
  • Cramps: - How to get rid of cramps : How to get rid of cramps breathing exercise - Leg cramps at night : Two easy solutions (Earthing and reduced breathing exercise).[normalbreathing.com]
Emotional Outbursts
  • Presenting complaints were dyspnea (61%), paresthesia (35%), chest pain or tightness (43%), muscle spasm (9%), dizziness (13%), palpitations (13%), and panic (30%). Similar previous episodes were reported in 74%.[ncbi.nlm.nih.gov]
  • Overview Hyperventilation syndrome is one of the most common causes of dizziness and paresthesias presenting to neurologists, and yet, it is underdiagnosed.[medlink.com]
  • Most commonly, the history is one of sudden onset of dyspnea, chest pain, or neurologic symptoms (eg, dizziness, weakness, paresthesias, or near-syncope) after a stressful event.[emedicine.medscape.com]
  • The symptoms typically associated with chronic HVS include faintness, dizziness, and visual disturbances. Chronic HVS is due to exaggerated upper thoracic movement as the diaphragm is not engaged.[ndhealthfacts.org]
  • Patients with acute hyperventilation syndrome (HVS) may present with agitation and anxiety.[emedicine.medscape.com]
  • Symptoms of Acute HVS are often more dramatic than Chronic HVS and may include breathlessness or the inability to catch one’s breath, agitation, rapid and/or deep breathing, chest pain, dizziness, heart palpitations and loss of consciousness.[ndhealthfacts.org]
  • This lower level of carbon dioxide reduces blood flow to the brain, which may result in the following nervous system and emotional symptoms: Weakness Fainting Dizziness Confusion Agitation A feeling of being outside yourself Seeing images that aren't[emedicinehealth.com]
  • ACUTE ATTACK - agitation, rapid upper chest breathing and heart-rate, chest pains, shortness of breath, nausea, tingling dizziness, clammy hands, dilated pupils, perhaps fainting and general weakness.[familydoctor.co.nz]
  • Signs and Symptoms OF XANAX addiction Mood symptoms • Depression • Anxiety • Mood swings • Hyperactivity • Rage • Agitation • Mania • Restlessness 57.[slideshare.net]


  • Approach Considerations • Patients with a history of HVS who have undergone an appropriate workup at some earlier time may not need any further laboratory evaluation in the setting of a recurrence.[slideshare.net]
  • Acute hypocapnia decreases CBF, increases hemoglobin affinity for oxygen and causes cerebral tissue hypoxia. This tissue hypoxia is reversed with inhalation of 100% O2 in dogs.[ncbi.nlm.nih.gov]
  • Symptoms of hypocapnia due to the (pre-)intervention as well as any adverse events will be reported and analysed.[clinicaltrials.gov]
  • Granholm L, Siesjö BK (1969) The effects of hypercapnia and hypocapnia upon cerebrospinal fluid lactate and pyruvate concentrations and upon the lactate, pyruvate, ATP, ADP, phosphocreatine and creatine concentrations of cat brain tissues.[link.springer.com]
  • In reality, they have about the same oxygenation in the arterial blood (normal values are about 98% for hemoglobin saturation) and too little carbon dioxide ( hypocapnia ) in their blood and other tissues.[en.wikipedia.org]
  • The U-B PCO2 decreased from a control of 22 /-1 mm Hg (mean /-SEM) to 11 /-2 mm Hg (mean /-SEM) with hypocapnia, and rose again to its control value when the blood PCO2 returned to prehyperventilation values.[jci.org]


  • Treatment Group 1 (TG1, n 36) : Mean Age 28yr; Gender: Male 27, Female 9; Mean GCS 5.6. Treatment Group 2 (TG2, n 36) : Mean Age 34yr; Gender: Male 22, Female 14; Mean GCS 5.6.[abiebr.com]
  • Although no patients presented with clinical features of asthma, 7 (30%) were known asthmatics receiving treatment and another 10 (44%) had a history and investigation results suggestive of asthma.[ncbi.nlm.nih.gov]
  • Both treatment programs were equally effective in reducing symptoms, said Meuret. But CART was the only treatment to physiologically alter panic symptoms by actively reversing hyperventilation in the patients.[sciencedaily.com]
  • Treatment for hyperventilation depends on the cause. Home treatment is usually all that is needed for mild hyperventilation symptoms.[northshore.org]


  • Prognosis Prognosis is generally good but will depend on the underlying cause and comorbidity. [ 12 ] Management of associated disorders (such as agoraphobia) will alter the course of the hyperventilation.[patient.info]
  • Pneumothorax (Symptoms, Causes, Types, and Prognosis) A pneumothorax is free air in the chest outside the lung, that causes the lung to collapse (collapsed lung). There are two types...[medicinenet.com]
  • Without the complete withdrawal of medication on long term, a definite healing is impossible Nevertheless that the patient has the subjective feeling of despair about the possibility of healing, the prognosis with the right treatment is good.[15minutes4me.com]
  • Hyperventilation Prognosis With appropriate training, a person may use stress -reduction techniques, breathing exercises, and certain medications to reduce the number and severity of the hyperventilation attacks.[emedicinehealth.com]
  • Severe prognosis in a large family with hypokalemic periodic paralysis. Muscle Nerve 2003 ; 27 : 165 –9 8 Geffner I, Murgatroyd J. Tetany. A case induced by hysterical hyperventilation. Br Dent J 1980 ; 148 : 264 9 Day JW, Parry GJ.[academic.oup.com]


  • Because of its bizarre manifestations and its basic etiology, it is seen by everyone regardless of the limitation of one's practice. Too many of us have been lulled into a sense of false security by medical school teachings.[aafp.org]
  • Practically all categories in the chapter could be designated 'not otherwise specified', 'unknown etiology' or 'transient'.[icd10data.com]
  • The patient benefits from explanations of laboratory tests and treatment. respiratory alkalosis Metabolism A condition characterized by pH due to excess CO 2 excretion Etiology Hyperventilation–eg, due to anxiety, pain, panic attacks, psychosis, CVA,[medical-dictionary.thefreedictionary.com]
  • Etiology • Proprioceptors in the lung and chest wall signal the brain with a “suffocation alarm” that triggers release of excitatory neurotransmitters that are responsible for many of the symptoms such as palpitations, tremor, anxiety, and diaphoresis[slideshare.net]


  • Epidemiology It is quite common but precise prevalence is unknown.[patient.info]
  • Epidemiology • As many as 10% of patients in a general internal medicine practice are reported to have HVS as their primary diagnosis. • The peak incidence is between the ages of 15 and 55 years, but cases have been reported in all age groups except infants[slideshare.net]
Sex distribution
Age distribution


  • […] from Greek: ὑπέρ ("iper") - over and Latin: ventilare - breathe German : Hyperventilation Contents 1 Definition 2 Forms 3 Pathophysiology 4 Symptoms 5 Therapy 1 Definition Hyperventilation is defined as unphysiological deeper and/or faster breathing that[flexikon.doccheck.com]
  • Lewis contended that acute and chronic hyperventilation syndrome occurred frequently and described the common and atypical presentations, pathophysiology, and therapy ( Lewis 1953 ).[medlink.com]
  • The pathophysiology of hyperventilation disorders. Chest 1996 ; 109 : 516 –34 3 Contreras G, Gutierrez M, Beroiza T, et al . Ventilatory drive and respiratory muscle function in pregnancy. Am Rev Respir Dis 1991 ; 144 : 837 –41 4 Moore EW.[academic.oup.com]
  • Nasal congestion, rhinitis, and related conditions: - Nasal congestion : Its causes, mechanism, and treatment - Sinusitis : Causes, pathophysiology, and treatment - How to get rid of a stuffy nose : a very easy breathing exercise - Runny nose : Causes[normalbreathing.com]
  • The pathophysiology of hyperventilation disorders. Chest . 1996;109:516–34. ... 2. Saisch SG, Wessely S, Gardner WN. Patients with acute hyperventilation presenting to an inner-city emergency department. Chest . 1996;110:952–7. 3. Singer EF.[aafp.org]


  • The book is arranged in eight sections concentrating on topics such as prevention of emergencies through patient evaluation (medical history) and specific types of more common emergencies that practitioners may encounter.[books.google.com]
  • 21:01:24 Hello - just a quick comment, I kept having episodes a while ago where I wasnt ble to breathe, went clammy etc etc (turned out they were to do with what I ate and stress) the results of whch were an asthma type reaction - dr gave me both a preventative[mumsnet.com]
  • This means that if you can stop hyperventilating, you can potentially reduce the severity of your panic attacks and perhaps prevent them altogether.[calmclinic.com]
  • Examples of medications for hyperventilation include: alprazolam (Xanax) doxepin (Silenor) paroxetine (Paxil) Preventing hyperventilation You can learn breathing and relaxation techniques to help prevent hyperventilation.[healthline.com]
  • You, your friends, and family can learn techniques to stop it from happening and prevent future attacks. If you start hyperventilating, the goal is to raise the carbon dioxide level in your blood. This will end most of your symptoms.[medlineplus.gov]

Ask Question

5000 Characters left Format the text using: # Heading, **bold**, _italic_. HTML code is not allowed.
By publishing this question you agree to the TOS and Privacy policy.
• Use a precise title for your question.
• Ask a specific question and provide age, sex, symptoms, type and duration of treatment.
• Respect your own and other people's privacy, never post full names or contact information.
• Inappropriate questions will be deleted.
• In urgent cases contact a physician, visit a hospital or call an emergency service!