ABSTRACT

Restrictive lung disease is a broad term, encompassing a number of condi-

tions in which lung volumes are reduced. The hallmark of many restrictive

lung diseases is a decrease in the compliance of the lung and/or chest wall.

Dyspnea is a common clinical manifestation of restrictive lung disease and frequently becomes a prominent and disabling symptom for patients with

more advanced restriction. In recent decades, our understanding of the

mechanisms of dyspnea in restrictive lung disease has been furthered by a

small, but significant, body of research. This chapter will review the existing

literature on this subject. The main focus will be on interstitial lung disease

(ILD), because it is the prototypical restrictive disease. However, other

causes of restriction will also be discussed, including pleural disease, neuro-

muscular disease, obesity, and congestive heart failure. Although the pathology of these conditions are clearly disparate, closer scrutiny suggests

that they may share certain physiologic characteristics and that some

mechanisms of dyspnea may be common to many, if not all, restrictive lung

diseases.