Orthopnea is often quantified by the number of what used to prop up the head?

• A. Pillows
• B. Time to exhale
• C. Number of pillows used to prop up the head
• D. Blood pressure

Answer: (C)

Quantifying orthopnea relies on how many pillows a patient needs to prop up the head to relieve shortness of breath when lying flat. The more pillows required, the more severe the orthopnea, because lying flat increases venous return and pulmonary congestion, which the raised head position helps to lessen. This bedside measure gives a quick sense of symptom severity and helps guide treatment decisions, such as adjustments in diuresis or exercise/positioning strategies. Time to exhale and blood pressure aren’t used to grade orthopnea, and simply stating “pillows” without specifying how many misses the practical clinical meaning.