Introduction Breathlessness, or dyspnea, has been defined as breathing that is difficult, laborious, or uncomfortable; it has also been described as unpleasant but painless. 1-3 The term denotes a set of subjective sensations of varying degrees of intensity. Shortness of breath is the most common symptom in cardiac or pulmonary diseases, 4,5 and it is often found accompanying a wide range of disorders involving gas exchange, pulmonary circulation, respiratory mechanics, and cardiovascular abnormalities. 6 Pregnant women and healthy persons also find breathing difficult during intense exercise and describe it as shortness of breath. Correspondence: Dr. J.C. Vázquez-García. Calzada de Tlalpan, 4.502. 14080 México DF. México. E-mail: jcvaz@prodigy.net.mx Manuscript received April 28, 2005. Accepted for publication September 27, 2005. Arch Bronconeumol. 2006;42(5):211-7 211 ORIGINAL ARTICLES Descriptors of Breathlessness in Mexican Spanish J.C. Vázquez-García, a C.A. Balcázar-Cruz, a G. Cervantes-Méndez, a R. Mejía-Alfaro, a J. Cossío-Alcántara, b and A. Ramírez-Venegas c a Departamento de Fisiología Respiratoria, Instituto Nacional de Enfermedades Respiratorias, México DF, Mexico. b Departamento de Hospitalización, Instituto Nacional de Cardiología Ignacio Chávez, México DF, Mexico. c Clínica de EPOC, Instituto Nacional de Enfermedades Respiratorias, México DF, Mexico. OBJECTIVE: Breathlessness is the most common symptom of cardiovascular or pulmonary disease. The term encompasses a wide range of descriptors used by patients, however. Identifying those descriptors can be useful for analyzing symptoms and understanding how they arise. The aim of this study was to characterize the descriptors of breathlessness used in Mexican Spanish and to consider their association with various states of respiratory distress and cardiovascular or pulmonary disease. MATERIAL AND METHODS: A questionnaire was based on 21 descriptors of breathlessness, some of which had no equivalents in English. The subjects included 15 healthy individuals during a cardiopulmonary stress test, 13 healthy subjects after a carbon dioxide rebreathing procedure, and 10 healthy women during pregnancy. We also included 16 patients with confirmed heart disease in stable condition, 15 patients during exacerbation of asthma, 20 with stable chronic obstructive pulmonary disease, and 15 with diffuse interstitial lung disease also in stable condition. Descriptors of breathlessness were then grouped based on the results of cluster analysis. RESULTS: Seven clusters of phrasal descriptors were identified as possibly representative of types of dyspnea. These clusters of descriptors were categorized as follows: agitation, suffocation, smothering, inhalation, exhalation, panting, and rapidity. Associations between types of dyspnea and the groups of participants were identified based on how frequently they used the terms. CONCLUSIONS: At least 7 clusters or groups of descriptors of breathlessness were identified as equivalent to 7 types of dyspnea; some items have no equivalent in English. Healthy subjects with respiratory distress or certain groups of patients with cardiovascular or pulmonary disease are associated with certain types of dyspnea. Key words: Dyspnea. Descriptors of breathlessness. Cluster analysis. Asthma. Chronic obstructive pulmonary disease. El lenguaje de la disnea. Una visión desde el español de México OBJETIVO: La disnea es el síntoma más frecuente en la en- fermedad cardiovascular o pulmonar. Sin embargo, el tér- mino engloba un número variado de descriptores que suelen usar o identificar los pacientes. Identificar estos descriptores puede ser de utilidad semiológica y para la compresión de su patogenia. El objetivo del presente estudio ha sido caracteri- zar los descriptores de disnea utilizados en español mexica- no y su asociación con diferentes estados de estrés respirato- rio o enfermedad cardiovascular o pulmonar. MATERIAL Y MÉTODOS: Se estructuró un cuestionario de dis- nea basado en 21 descriptores, algunos sin equivalentes en idio- ma inglés. Se estudió a 15 sujetos sanos durante una prueba de ejercicio cardiopulmonar, a 13 durante una prueba de hiper- capnia y a 10 mujeres embarazadas. Asimismo, se incluyó a 16 pacientes estables con cardiopatía demostrada, a 15 pacientes con crisis asmática, a 20 con enfermedad pulmonar obstructiva crónica estable y a 15 con neumopatía intersticial difusa tam- bién estable. La agrupación de los diferentes descriptores de disnea se determinó por análisis de conglomerados. RESULTADOS: Se encontraron 7 conglomerados o asociacio- nes de descriptores que pueden interpretarse como tipos de disnea. Estos grupos de frases descriptivas se pueden englo- bar bajo los siguientes conceptos: agitación, asfixia, sofoca- ción, inhalación exhalación, jadeo y rapidez. Se encontraron algunas asociaciones entre tipos de disnea y los grupos estu- diados sobre la base de la frecuencia de uso de los términos. CONCLUSIONES: Existen al menos 7 conglomerados o aso- ciaciones de descriptores de disnea que equivalen a 7 tipos de disnea; algunos de los descriptores carecen de equivalen- te en inglés. Los sujetos sanos en estrés respiratorio o algu- nos grupos de pacientes con enfermedad cardiovascular o pulmonar se asociaron a tipos específicos de disnea. Palabras clave: Disnea. Decriptores de disnea. Análisis de conglo- merados. Asma. Enfermedad pulmonar obstructiva crónica