Elsevier

American Heart Journal

Volume 14, Issue 3, September 1937, Pages 255-267
American Heart Journal

Original communication
Trepopnea as an etiological factor in paroxysmal nocturnal dyspnea

https://doi.org/10.1016/S0002-8703(37)90563-5Get rights and content

Abstract

Trepopnea is an etiological factor in the production of paroxysmal nocturnal dyspnea. In certain patients the relationship is definite. In others, however, the two syndromes are not obviously related. Many persons with trepopnea do not experience paroxysms of nocturnal dyspnea. Some are wakened, when they assume an unfavorable recumbent position during sleep, by symptoms other than dyspnea: especially pain, palpitation, and cough. Some are able to avoid their unfavorable recumbent positions subconsciously, without waking. If a trepopneic individual becomes unconscious or paralyzed, the responsibility for avoiding an unfavorable position may devolve upon the physician and nurse.

Patients with mild degrees of trepopnea usually are capable of sleeping in their most unfavorable recumbent positions. However, if further impairment of blood flow from the lungs to the aorta occurs, either temporary or permanent, the assumption of an unfavorable position during sleep may initiate a severe attack.

The demonstration that trepopnea is a precipitating factor in paroxysmal nocturnal dyspnea supplies an explanation for the onset of attacks in certain cases where formerly no adequate cause was recognized.

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