THE HYPERVENTILATION SYNDROME

Abstract

The hyperventilation syndrome is generally considered an acute, transitory but relatively uncommon episode that is characterized by gross hyperpnea and culminates in frank tetany. Observations are presented which suggest that hyperventilation mechanisms occur quite frequently and, contrary to prevalent opinion, tend to pursue a chronic, fluctuating course more often than one featuring brief, explosive attacks with asymptomatic intervals. The initiating factors may be organic or psychogenic and the symptom-complex may be demonstrated by emotionally stable as well as unstable subjects. Although most often psycho-genically precipitated, hyperventilation patterns may be superimposed upon, and thus distort, serious organic disease processes. The chronic syndromes characteristically masquerade behind symptoms referable to localized structures (e.g., the heart and gastrointestinal tract) which are not commonly linked with hyperventilation mechanisms. The resultant clinical pictures are confusing and their diagnoses difficult. Representative case reports of patients with this syndrome are presented to demonstrate the cardinal manifestations, the underlying pathophysiologic mechanisms, the typical clinical pictures, and the effective therapeutic measures.