STUDIES OF BREATHING, PULMONARY VENTILATION AND SUBJECTIVE AWARENESS OF SHORTNESS OF BREATH (DYSPNEA) IN NEUROCIRCULATORY ASTHENIA, EFFORT SYNDROME, ANXIETY NEUROSIS 1

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Abstract
Studies of breathing, pulmonary ventilation and dyspnea were done in 74 patients with neurocirculatory asthenia (anxiety neurosis, effort syndrome) and in 129 control subjects. The studies included investigations of: (1) patients'' symptoms as compared with those of control subjects; (2) study of characteristics of breathing at rest, including respiratory rate, minute respiratory volume, tidal air, O2 consumption, incidence of sighs, variation in respiratory rate and in respiratory depth; (3) studies of breathing during exercise, of ventilation index, and of the relation of ventilation index to awareness of shortness of breath, i.e., dyspnea; (4) studies of ventilation and ventilatory efficiency while walking and running on a treadmill. The conclusions from these studies are: In neurocirculatory asthenia, effort syndrome, or anxiety neurosis there are many symptoms referable to respiration; at rest, while breating O2, patients show rapid respiratory rate and abnormally shallow breathing; while breathing air, minute respiratory volume is significantly higher in N.C.A. at rest and during moderate exercise than in controls, becoming lower as hard exercise progresses; the greatest disproportion in pulmonary ventilation between patients and controls occurs in the early mins. of the recovery period after exercise, suggesting a relation to the high blood lactate and oxygen debt mechanism; vital capacity is normal in neurocirculatory asthenia; ventilation index, an objective correlate of dyspnea, is high in neurocirculatory asthenia; the incidence and degree of dyspnea are out of proportion to the severity of exercise, the pulmonary ventilation, or the ventilation index in N.C.A.; and ventilatory efficiency is low in neurocirculatory asthenia both in moderate and in severe muscular exercise.

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