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Medical background and missed diagnoses

Ever since 1900 scientific publications regarding the hyperventilation syndrome have appeared. Typically these documents concerned the psycho-socially induced respiratory alkalosis, rather than the primarily organic triggered hyperventilation. Despite the huge amount of knowledge regarding this illness, the diagnosis hyperventilation is remarkably often missed.

Under the headline ‘hyperventilation syndrome’ in the medical text books and manuals, only the classic triad is mentioned: massive and evident hyperventilating, paresthesia around the mouth and acra, tetanies. Contrary to the general assumption, like the hyperventilation syndrome would only manifest itself through acute attacks of fast breathing with the classic set of symptoms, it appeared that chronic hyperventilation is much more common.

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Why is the diagnose hyperventilation missed so often?

Reasons why this diagnosis is missed so often are among others:

  • the unfamiliarity of the physicians with the phenomenon. The illness as such is not part of the medical text books and manuals, and is only a very small part of the future physician’s education.
  • A typical and peculiar discrepancy in the presentation of the symptoms by the patient: the degree of anxiety of the patient versus the lack of objective signs of a conventional syndrome. The vagueness of the symptom presentation is explained by the patient’s dire need for some physical explanation. This causes uncertainty on the doctor’s side, who can easily get irritated and will then be inclined to reassure the patient by telling “there is nothing wrong, it’s probably just nerves”.
  • Symptoms that seem to point in certain directions, are too eagerly used to redirect the patient to a specialist, who then also cannot find anything wrong with the patient. In some cases the physician feels cheated by the patient, after he examined symptoms that seem to indicate malfunctions in the tractus circulatorius, tractus digestivus, thyroid gland or central nervous system.

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