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August 1990


Arch Intern Med. 1990;150(8):1604-1613. doi:10.1001/archinte.1990.00040031604007

There is no universally accepted definition of dyspnea, but everybody has experienced the sensation and thus has an intuitive understanding of the phenomenon. At a symposium on breathlessness in 1965, Julius H. Comroe1 outlined his concept of dyspnea. It "is difficult, labored, uncomfortable breathing; it is an unpleasant type of breathing, though it is not painful in the usual sense of the word. It is subjective and, like pain, it involves both perception of the sensation by the patient and his reaction to the sensation." In his closing remarks2 at the end of the symposium, he returned to this issue.

We have learned here that there are five or six different grades or types of this sensation. One is an awareness that there is a little increase in ventilation. Another is a little shortness of breath ('harder to get one's breath') and this may be slightly unpleasant. Another is an

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