Orthopnea is best described as which of the following?

• A. Shortness of breath that worsens when standing
• B. Shortness of breath that worsens when lying flat
• C. Shortness of breath that improves with exercise
• D. Chest pain when coughing

Answer: (B)

Orthopnea is the shortness of breath that worsens when lying flat. When a person lies down, more blood returns to the heart, increasing the pressure in the pulmonary vessels and causing fluid to push into the lungs, which makes breathing feel harder. Sitting up or standing reduces venous return and allows the lungs and chest to expand more easily, relieving the symptoms. In rehab, recognizing orthopnea helps identify heart-related dyspnea rather than a purely lung or muscular issue. The other patterns don’t fit because dyspnea that worsens with standing describes a different positional effect, dyspnea that improves with exercise isn’t characteristic of orthopnea, and chest pain with coughing is a separate symptom not defined by body position.