Step 1 : Introduction to the question "2. Mrs. Apple suffers from congestive heart failure. Recently she has been experiencing NOCTURNAL dyspnea (difficulty in breathing). When is Mrs. Apple having these dyspneic episodes?"
...1. At night 2. During the day 3. When she has to use the bathroom 4. When she has significant stress The distinctive adjective "nocturnal" pertains to night. Paroxysmal nocturnal dyspnea (PND) can be a manifestation of congestive heart failure. One theory which explains this feature is as follows: during the day, when the individual is in a vertical position, fluid tends to pool in the dependent body parts, the legs. This causes swelling of the legs. When the individual assumes a horizontal position to sleep, the fluid is redistributed centrally and becomes too much for the heart to handle. Fluid pools in the lungs and the individual manifests with an acute episode of shortness of breath, wheezing, coughing and anxiety due to feelings of suffocation.
Step 2 : Answer to the question "2. Mrs. Apple suffers from congestive heart failure. Recently she has been experiencing NOCTURNAL dyspnea (difficulty in breathing). When is Mrs. Apple having these dyspneic episodes?"
At night:
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