Hyperventilation

Presentation

The patient presenting with hyperventilation syndrome typically appears anxious and exhibits shortness of breath with an inability to fill the lungs adequately. The patient also may have palpitations, dizziness, intense anxiety, fear, chest or abdominal pain, tingling or numbness around the mouth and fingers, and possibly even flexor spasm of the hands and feet (carpopedal spasm) ( Fig. 3.1 ). The patient’s respiratory volume is increased, which may be apparent as increased respiratory rate, increased tidal volume, or frequent sighing. The remainder of the physical examination is unremarkable. The patient’s history may reveal a precipitating emotional cause or prior similar events. The patient may experience alternating periods of hypoventilation or brief periods of apnea as the body tries to allow carbon dioxide (CO ₂ ) levels to drift back up to the normal range. If this occurs, the pattern is usually abrupt onset of transient apnea without a drop in O ₂ saturation, immediately preceded and followed by profound hyperventilation.