Hyperventilation syndrome

Not to be confused with Hypoventilation.
Hyperventilation syndrome.
SpecialtyPsychiatry, neurology, pulmonology Edit this on Wikidata

Hyperventilation syndrome (HVS), also known as chronic hyperventilation syndrome (CHVS), dysfunctional breathing hyperventilation syndrome, cryptotetany,[1][2] spasmophilia,[3][4][5] latent tetany,[4][5] and central neuronal hyper excitability syndrome (NHS),[3] is a respiratory disorder, psychologically or physiologically based, involving breathing too deeply or too rapidly (hyperventilation). HVS may present with chest pain and a tingling sensation in the fingertips and around the mouth (paresthesia), in some cases resulting in the hands 'locking up' or cramping (carpopedal spasm).[6] HVS may accompany a panic attack.

People with HVS may feel that they cannot get enough air. 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. While oxygen is abundant in the bloodstream, HVS reduces effective delivery of that oxygen to vital organs due to low-CO2-induced vasoconstriction and the suppressed Bohr effect.

The hyperventilation is self-promulgating as rapid or deep breathing causes carbon dioxide levels to fall below healthy levels, and respiratory alkalosis (high blood pH) develops. This makes the symptoms worse, which causes the person to breathe even faster, which then, further exacerbates the problem.

The respiratory alkalosis leads to changes in the way the nervous system fires and leads to the paresthesia, dizziness, and perceptual changes that often accompany this condition. Other mechanisms may also be at work, and some people are physiologically more susceptible to this phenomenon than others.[7]

The mechanism for hyperventilation causing Paresthesia, lightheadedness, and fainting is: hyperventilation causes increased blood pH (see Respiratory alkalosis for this mechanism), which causes a decrease in free ionized calcium (Hypocalcaemia), which causes paresthesia and symptoms related to hypocalcaemia.

  1. ^ Seelig, MS; Berger, AR; Spielholz, N (August 1975). "Latent Tetany And Anxiety, Marginal Magnesium Deficit, And Normocalcemia" (PDF). Dis Nerv Syst. 36 (8): 461–5. PMID 1164868. S2CID 6696448. Archived from the original (PDF) on 2019-09-12.
  2. ^ "Review and Hypothesis: Might Patients with the Chronic Fatigue Syndrome Have Latent Tetany of Magnesium Deficiency".
  3. ^ a b "Spasmophilia in the Cardiological Outpatient Department: A Retrospective Study of 228 Sub-saharan Africans over 5 Years". ResearchGate. Retrieved 2019-09-14.
  4. ^ a b Toruńska, Katarzyna (May 2003). "[Tetany as a difficult diagnostic problem in the neurological outpatient department]". Neurologia I Neurochirurgia Polska. 37 (3): 653–664. ISSN 0028-3843. PMID 14593759.
  5. ^ a b Bongi, Susanna Maddali; Del Rosso, Angela; Lisa, Diana; Orlandi, Martina; De Scisciolo, Giuseppe (September 2015). "Ischemia-hyperpnea test is useful to detect patients with fibromyalgia syndrome". European Journal of Rheumatology. 2 (3): 89–95. doi:10.5152/eurjrheum.2015.0094. ISSN 2147-9720. PMC 5047258. PMID 27708937.
  6. ^ "Hyperventilation Syndrome Clinical Presentation: History, Physical Examination". emedicine.medscape.com. Retrieved 2024-05-24.
  7. ^ Cite error: The named reference Edward Newton was invoked but never defined (see the help page).