Hyperventilation Syndrome - The Great Medical Mimic

Do you get short of breath sometimes? Have you noticed that you get tingling in your hands and feet or in your face? Do you get nightmares, headaches and irritable bowel? Do you get sudden episodes of fatigue? These are the common symptoms of hyperventilation syndrome, which is known in modern medicine as “the great mimic”.

The most common symptoms include up to five different types of chest pain, including:

• A lancing sharp pain, which is due to forceful heartbeats against the chest wall, and also dull aching type of chest pain
• Air hunger
• “Cottonwool” in the head
• Tiredness
• Tingling in the hands, feet and face
• Anxiety – can mimic a panic attack
• Sweating
• Panic
• Irritable bowel.
• Headache, even migraine
• Neurological symptoms
• Blocked throat and sinuses.

Hyperventilation syndrome is a syndrome of disordered breathing that causes many different physical symptoms that can be confused with other health conditions. It has been known about since the time of the American Civil War when Dr de Costa first called it “irritable heart”, when the young soldiers were complaining of chest pain from stress. It is more common in women and more common in people with asthma who have problems related to breathing, blocked noses, etc. About one in twelve people get it.

The diagnosis can be made by reproducing all the symptoms on asking the person to over breathe. To help with diagnosis, the person’s upper chest moves rapidly and there is no abdominal breathing, and this signifies that the diaphragm is not moving properly.

In addition to those who have breathing situations to cause risk, other people who are more at risk are those who are stressed, ambitious and perfectionistic. It can be an occupational hazard for singers, actors, public speakers and anyone who has to concentrate on their breathing at times, e.g. swimmers, wind players and asthmatics.

What actually happens is that breathing is usually automatic and you don’t have to think about it. But when you breathe too fast as a result of tension or just habit from chronic stress, there is increased muscle tension and biochemical changes in the body due to low carbon dioxide levels.

A person can suspect the condition if they can’t take a deep breath, notice a lot of sighing or yawning, and have any of the symptoms already mentioned. Commonly, a person has had a lot of tests and consultations for symptoms where a diagnosis cannot be made. A researched questionnaire you can find online is called the Nijmegen Questionnaire where a score of over 23 suggests the problem is disordered breathing.

The treatment involves identifying the problem first and then helping the person with stress management if required, and education. Referring them to someone who can help them breathe correctly like a breathing physiotherapist or a Buteyko practitioner, can be very useful.

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