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Hyperventilation syndrome (HVS)—characterized by panic attacks—and asthma have some symptoms in common. Research has established a connect between the two conditions. Having one ups the risk of having the other.

But they are two different ailments. And they need to be treated differently.

The right diagnosis

Ranganath R., senior consultant pulmonologist at Narayana Health City, Bengaluru, shares the case of a 45-year-old asthmatic who works as a marketing executive. She suffered breathing trouble about a year ago, and was prescribed a high dose of asthma drugs. When the medicines had no effect, she went back to the doctors. They found she was actually suffering from HVS, not asthma.

“We treated her with anti-anxiety medicines and psychotherapy, and she has not had a follow-up panic attack since," says Dr Ranganath. “It is important,’’ he adds, “to distinguish between the two carefully as the some of the symptoms tend to overlap."

A 20-year study of nearly 600 adults in Switzerland found that the two conditions are connected. Having asthma increased the risk of developing panic disorder 4.5-fold, while people with panic disorder were six times more likely to develop asthma. The study was published in June 2005 in the American Journal Of Respiratory And Critical Care Medicine.

The main symptom they have in common is breathlessness. And this can lead to a wrong diagnosis, particularly if medical staff just take note of this symptom without checking other parameters.

“While asthma is a distressing and potentially dangerous condition caused by obstruction of the airways due to inflammation, HVS usually occurs owing to excessive stress or workload," says Harnish Vohra, consultant pulmonology and critical care, at Columbia Asia hospital in Ghaziabad, near New Delhi.

HVS has no genetic connect and, unlike asthma, no link to seasonal or weather change, says Dr Vohra.

In asthma, swelling of the lungs leads to a high breathing rate, and the oxygen level goes down to 50-60%. “Anxiety can precipitate it, so can seasonal changes like rain, extreme winter and moisture, etc. Plus, genes and family history also have a say," says Dr Vohra.

In HVS, oxygen levels tend to be normal because there is no inflammation of the lungs. Its symptoms can be tackled by explaining the problem and reassuring the patient; sedatives can help.

“Treatment for panic attacks includes counselling, psychiatric consultation, regular exercises and respiratory training during attacks. For asthma, the treatment is completely different, relying more on continued medication and prevention," says Dr Ranganath.

“We advise all asthma patients to avoid allergens, unnecessary antibiotics and smoking to prevent anxiety attacks," adds Dr Vohra.

Increasing numbers

Lately, there has been a significant rise in the number of patients suffering from HVS owing to high stress levels, says Dr Vohra. “While asthma is more related to rising pollution, stress tends to precipitate panic attacks. Keeping stress in check is an important preventive method to keep HVS at bay," he adds.

Most people with HVS are in the 15-55 age group, says Dr Ranganath. “While there is no definitive data on HVS, it roughly occurs in 5-6% of the general population," he adds. “At Narayana Health City, 10% of the patients who come in for general consultation suffer from HVS. Although the reason is not clear, the ratio of the condition is 1:7; females are seen to be more prone to it than males."

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