Breathing Problems, Difficulty in Parkinson’s Disease

Normal aging should not cause breathing difficulty and people with Parkinson’s disease, although mostly elderly, should not have breathing problems unless there is some underlying cause. Getting out of breath on undertaking unaccustomed exercise is not really a cause for concern.

It is quite possible, however, for a person with Parkinson’s disease to also suffer from some pre-existing lung or heart condition which may cause some amount of breathing difficulty. If shortness of breath, wheezing, cough or chest discomfort does develop, even without a known medical problem, careful assessment and treatment is definitely indicated.

Causes of Breathing Difficulty in Parkinson’s Disease

Dyspnea, breathing difficulty, or shortness of breath – whatever you may choose to call it – can be very distressing, and even frightening, for the person who suffers with it, especially if there have been severe episodes. The causes could be any of the following :

  • Chronic lung diseases such as COPD (chronic obstructive pulmonary disease), chronic asthma, emphysema and chronic bronchitis or an acute exacerbation, can cause shortness of breath accompanied by wheezing, cough or chest discomfort.
  • Pneumonia.
  • Pulmonary embolism.
  • Pulmonary hypertension.
  • Heart failure and other heart conditions such as myocardial infarction (heart attack).
  • Stroke. The symptoms of a stroke may sometimes be missed in the late stages of Parkinson’s disease as caregivers may mistaken the presentation for the progression of Parkinson’s disease.
  • Choking on an object.
  • Severe anemia.
  • Allergic reactions. This should be monitored carefully to assess if the reaction is caused by any medication.
  • Common cold, sinusitis or other nasal problems.
  • High fever.
  • Associated diseases such as lung cancer or tuberculosis.
  • Anxiety or panic attacks. Parkinson’s disease patients often suffer from depression, anxiety disorders, dementia and other emotional problems. This could sometimes be the cause of hyperventilation and breathing problems. When all other causes have been excluded, this diagnosis should be kept in mind.

Shortness of breath could be due to any of the above causes or it may be a symptom of end stages of Parkinson’s disease.

Risk Factors

The associated risk factors may include :

  1. Air pollution.
  2. Smoking.
  3. High altitude.
  4. Obesity.

Diagnosis

It is important to diagnose the cause of the breathing difficulty. If the patient has a known medical condition other than Parkinson’s disease, diagnosis becomes easy. Even so, a thorough physical examination will need to be conducted along with other tests if indicated. This may include :

  • Blood tests, including arterial blood gases, especially oxygen saturation.
  • Chest x-ray.
  • ECG.
  • Echocardiogram.
  • Pulmonary function tests.
  • Spirometry.
  • Methacholine challenge test.
  • Allergy tests.
  • CT scan.

Prevention and Treatment

  • Regular exercise as appropriate, keeping in mind the condition of the patient suffering from Parkinson’s disease.
  • Giving up smoking is very important.
  • Immunization. Bed-ridden, depressed and immobile Parkinson’s disease patients are very susceptible to contracting infections because of their low immunity status. Appropriate vaccinations should be administered to prevent infections such as the flu and pneumonia.
  • A nutritious diet, including fruits and vegetables, help to build up the immune system. Vitamin and zinc supplements may also help. Avoid close contact with others who have a cold, flu or other infectious diseases.
  • Oxygen administration can help when breathing difficulty becomes severe. Hospitalization may become necessary at this stage.

5 Comments

  1. I am 69 yrs old. My world dramatically changed 10/29/08 when I knee replacement surgery. The Dr? missized the knee replacent causing it to be so loose that it caused me to fall. One which I broke a couple fo ribs and the other I tore a rotator cuff. Needless to say this caused a lot of stress. I then found another Dr? who basically did a cosmetic job on my knee on 10/6/09. After a long rehab I started having Parkinsons type systems. I was diagnosed at the Cleveland Clinic 10/10 that I did in fact have PD. I had all the Parkinsons symptons that are well published but in addition to those and are not even mentioned by the Parkinsons establishment are the breathing issues I have all my waking hrs. This plus stiffness in my lower jaw and neck. I’ve extensive pulmonary function tests at the Cleveland Cinic and Summa Hospital in Akron,O Prior to my third surgery 7/11/11 on my rt knee, which was done by a revision specialist at The Cleveland Clinic. I had 2 days of preoperative testing. Everything checked out good. I am seeing a psychiatrist for anxiety, ocd, and depression. That Dr’s solution is drugs which are not workig. So may I submit to you and this is my firm belief that this breathing issue is the direct result of my Parkinsons , which is the direct result of the stress of two botched surgeries. I do feel the cc got it right, But even now after 14+ weeks I have a lot of pain…… and frustration. Thank you for listening.

  2. I was diagnosed in 2003 at the age of 49 after having mild Parkinson’s symptoms and feel the breathing issues I have been experiencing are the affects of the disease. One of my first symptoms was a tightness in my chest after going on a 4 mile walk. This baffled me as I should have felt a surge in energy from this exercise with my lungs breathing deeply and efficiently. At the time I was walking, I had not yet been diagnosed.

    Anyway, I have experienced extreme stress in this past year with the decline in health of my elderly parents and the subsequent care of both of them added to my usual life’s stress. I will also add that the breathing issues have worsened these past few months with the symptoms of stiffness in my lower jaw and neck that you, Allen, describe.

    The stress in my life this year has been so extreme that I have also been diagnosed with having anxiety attacks. I feel this exacerbates the symptoms I experience with my breathing and Parkinson’s Disease. There doesn’t seem to be much written about this topic and I appreciate you bringing it up in this blog.

  3. I have had this Hyperventilating type breathing from my Parkinsons for about 6 months. The first time it happened I went to the emergency room. I was told I was hyperventilatig. I was told to take Ativan or breathe into a paper bag. I tried both suggestions and neither worked. A Doctor I was seeing suggested it could be that the muscles around the lungs are being compressed possibly from anxiety. I received a prescription for Vicodin which I took 1 pill every 8 hours. The results have been very good. I get about 3 to 4 hours relief out of each 8 hours. This equals 12 hours of relief for the day. Try it! You have nothing to lose.

  4. Two years ago, former Syracuse punter Rob Long was diagnosed with a brain tumor. The two-time captain had been suffering incurable headaches and nausea and his girlfriend encouraged him to see team trainers about the problem. On Dec. 2, 2010, after a multitude of tests, doctors told Long they had found malignant cells in his brain.

  5. I was diagnosed with Parkinson’s in 2011. I was told that I had asthma and chronic bronchitis. In 2013 I had a sleep study done because I felt so exhausted. They did not find apnea. What they did find is Nocturnal Hypoxemia. My pulmonary dr. (new) said I showed none of the traditional signs of asthma but in the past month I’ve had two bouts of tracheal bronchitis. I’m short of breath and exhausted. I’m on O2 at night for the hypoxemia. My pulmonary dr. feels it’s somehow related to my PD. I’m trying to find more information about this.

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