Hyperventilation is a breathing pattern characterized by rapid and deep breathing that exceeds the body’s metabolic demands, leading to a decrease in arterial carbon dioxide levels (hypocapnia).

Causes

Psychological factors:

• Anxiety disorders
• Panic attacks
• Stress

Medical conditions:

• Asthma
• Pulmonary embolism
• Pneumonia
• Diabetic ketoacidosis
• Sepsis

Other factors:

• Pain
• Fever
• High altitude
• Certain medications

Pathophysiology

• Increased respiratory rate and/or tidal volume
• Decreased arterial CO2 (PaCO2)
• Respiratory alkalosis
• Shift of the oxygen-hemoglobin dissociation curve to the left
• Vasoconstriction of cerebral blood vessels

Clinical Presentation

• Shortness of breath
• Chest tightness or pain
• Dizziness or lightheadedness
• Numbness or tingling in extremities
• Muscle spasms (tetany)
• Anxiety or panic

Diagnosis

• Clinical history and physical examination
• Arterial blood gas analysis
• Capnography
• Exclusion of other medical causes

Treatment

Acute management:

• Reassurance and calm environment
• Breathing techniques (e.g., pursed-lip breathing)
• Rebreathing into a paper bag (controversial)

Treatment of underlying cause:

• Psychotherapy for anxiety disorders
• Medication management for medical conditions

Patient education:

• Breathing exercises
• Relaxation techniques
• Trigger avoidance