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Hyperventilation syndrome
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Hyperventilation syndrome

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Contributors: Christine Osborne MD, David Sullo MD
Other Resources UpToDate PubMed

Synopsis

Hyperventilation is defined as ventilation in excess of metabolic requirements leading to reduction in partial pressure of arterial carbon dioxide (PaCO2) leading to symptoms of dyspnea, paresthesias, tetany, dizziness, headaches, visual disturbances, and atypical chest pain. The initiating event in hyperventilation leads to increased alveolar ventilation with subsequent drop in PaCO2 to ~20 mmHg.

This initial drop in PaCO2 leads to the symptoms described above with a subsequent increase in minute ventilation to help alleviate the symptoms, only to make them worse with ongoing hyperventilation. Patients often have negative evaluations for causes of their hyperventilation with resultant anxiety about future hyperventilation attacks.

While anxiety disorders and panic attacks may be both an initiating and sustaining factor for hyperventilation syndrome, they are not necessary for the development of chronic hypocapnia.

Codes

ICD10CM:
R06.4 – Hyperventilation

SNOMEDCT:
191956005 – Psychogenic hyperventilation

Differential Diagnosis & Pitfalls

Due to the nature of the symptoms that may arise during hyperventilation, the differential starts out quite varied and may include:

Best Tests

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References

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Last Updated: 03/28/2017
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Hyperventilation syndrome
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Hyperventilation syndrome : Chest pain, Dizziness, Anxiety, Heart palpitations, Diaphoresis, Dyspnea, Paresthesias, Presyncope, Sudden onset in minutes, RR increased
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