Hyperventilation syndrome is a poorly understood illness that mimics respiratory distress. When a patient appears to be air hungry, it is not wise to have him (her) breathe into a paper bag unless you are certain that the diagnosis is hyperventilation. A quick way to confirm hyperventilation is to employ the Chvostek maneuver. Contraction of the local facial musculature in response to tapping over the facial nerve indicates temporary hypocalcemia related to respiratory alkalosis-that is, more-than-adequate ventilation.
Dante Pappano, MDRochester, N.Y.
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