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Tachypnea: Causes, Symptoms and Treatment

Tachypnea refers to an abnormally rapid breathing rate. It can indicate various underlying conditions affecting the lungs, heart, or metabolism.

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Things worth knowing about "Tachypnea"

Tachypnea refers to an abnormally rapid breathing rate. It can indicate various underlying conditions affecting the lungs, heart, or metabolism.

What is Tachypnea?

Tachypnea is defined as an abnormally elevated respiratory rate. In adults, this means more than 20 breaths per minute; in children, age-specific thresholds apply. The term derives from the Greek words tachys (fast) and pnoe (breath). Tachypnea is not a disease in itself but a clinical symptom that can point to a wide range of underlying medical conditions.

Causes

Tachypnea can be triggered by numerous conditions, including:

Pulmonary conditions: Pneumonia, asthma, chronic obstructive pulmonary disease (COPD), pulmonary embolism, pneumothorax
Cardiac conditions: Heart failure, acute coronary syndrome
Metabolic disorders: Diabetic ketoacidosis, metabolic acidosis
Infections and sepsis: Severe systemic infections can significantly increase breathing rate
Neurological causes: Traumatic brain injury, brainstem involvement
Psychological causes: Anxiety disorders and panic attacks leading to hyperventilation
Anemia: Low blood oxygen levels trigger compensatory increased breathing
Fever: Elevated body temperature increases the body's oxygen demand

Symptoms and Associated Findings

Tachypnea often occurs alongside other symptoms that help identify the underlying cause:

Shortness of breath or dyspnea
Cyanosis (bluish discoloration of lips or fingernails due to low oxygen)
Chest pain
Coughing
Dizziness or light-headedness
Rapid heartbeat (tachycardia)
Feelings of anxiety or panic

Transient tachypnea of the newborn (TTN) is a distinct condition that may occur shortly after birth and is usually self-limiting, resolving within a few days.

Diagnosis

Diagnosis begins with a clinical assessment. The respiratory rate is measured by counting breaths per minute. To identify the underlying cause, the following investigations may be performed:

Pulse oximetry: Measures oxygen saturation in the blood
Arterial blood gas analysis (ABG): Evaluates oxygen, carbon dioxide, and acid-base balance
Chest X-ray: Visualizes the lungs and heart
Electrocardiogram (ECG): Assesses cardiac function
Blood tests: Inflammatory markers, complete blood count, metabolic panel
CT of the chest: Used when pulmonary embolism or structural lung changes are suspected

Treatment

Treatment of tachypnea is always directed at the underlying cause:

Oxygen therapy: Supplemental oxygen is provided via nasal cannula or mask when hypoxia is present
Treatment of the underlying condition: For example, antibiotics for pneumonia, bronchodilators for asthma, anticoagulants for pulmonary embolism
Ventilatory support: In severe cases, non-invasive or invasive mechanical ventilation may be required
Breathing exercises: Controlled breathing techniques can be helpful in psychogenic hyperventilation

Sudden-onset tachypnea accompanied by severe shortness of breath, chest pain, or altered consciousness is a medical emergency and requires immediate medical attention.

References

World Health Organization (WHO): Integrated Management of Childhood Illness (IMCI) - Tachypnoea thresholds in children. WHO, Geneva, 2014.
Longo DL et al. (eds.): Harrison's Principles of Internal Medicine, 20th edition. McGraw-Hill Education, 2018.
Epstein SK, Zilberberg MD: Respiratory Distress and Tachypnea. In: UpToDate, Wolters Kluwer, 2023.

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