Paroxysmal nocturnal dyspnea PND
Developes when a patient has been lying down for several hours. In this position, blood from the lower extermities is redistributed to the venouse system, which increase venous returntothe heart. A diseased heart cannot compensate for the increasedvolume and is ineffective in pumping the additionalfluid into the circulatory sytem. Pulmonary congestion results. Thepatients awakens abruptly,often wih a feeling of suffocation and panic.