Ukuphefumula kanzima wukuphazamiseka kokuphefumula okuhambisana nokubona ukuphefumula okungajwayelekile nokungajabulisi. Izinga lokuphefumula liyashintshwa; liyashesha noma liyehla. Isikhathi sokuphefumula nesikhathi sokuphelelwa umoya kungase kuthinteke.

Okuvame ukubizwa ngokuthi "i-dyspnea", kodwa futhi "ukuphefumula kanzima", ubunzima bokuphefumula kubangela umuzwa wokungakhululeki, ukuqina kanye nokuphefumula. Ukunyakaza ngakunye kokuphefumula kuba umzamo futhi akusazenzakaleli

Izimbangela eziyinhloko zokuphefumula kanzima yinhliziyo namaphaphu.

Izimbangela zamaphaphu kuqala zihlobene nezifo ezivimbelayo:

• Isifuba somoya singaphazamisa ukuphefumula. Kulokhu, imisipha ezungeze inkontileka ye-bronchi, eyehlisa isikhala lapho umoya ungadlula khona, izicubu ezifaka ngaphakathi kwe-bronchi (= i-bronchial mucosa) ziyacasuka bese zikhiqiza uketshezi oluningi (= isikhwehlela), kuqhubeke kunciphise isikhala yimuphi umoya ongazungeza.
• I-bronchitis engapheli ingaba umthombo wobunzima bokuphefumula; i-bronchi ivuvukele futhi ibangele ukukhwehlela nokukhafula.
• Ku-emphysema yamaphaphu, ubukhulu bamaphaphu buyanda futhi bunwebeka ngendlela engavamile. Ngokuqondile, izimbambo ziyakhululeka futhi azinzinzi, okuhambisana nokuwa kwemigudu yokuphefumula, okungukuthi ukuphefumula kanzima.
• Izinkinga zokutheleleka nge-coronavirus nazo zingadala ubunzima bokuphefumula. 

Ezinye izimbangela zamaphaphu yizifo ezivimbelayo:

• I-Dyspnea ingabangelwa i-pulmonary fibrosis. Ukushintsha kwezicubu zamaphaphu kuzicubu ze-pathological fibrous. Le fibrosis itholakala ezindaweni eziphakathi kwe-alveolar, lapho ukushintshana kwegesi komoyampilo kwenzeka.
• Ukususwa kobuthakathaka bephaphu noma bemisipha njengoba kwenzeka ku-myopathy kungabangela izinkinga zokuphefumula

Izinkinga zenhliziyo zimi kanje:

• Ukungajwayelekile kwama-valve wenhliziyo noma ukwehluleka kwenhliziyo okuzodala ubuthakathaka benhliziyo nenguquko kwengcindezi ezitsheni ezizothinta amaphaphu futhi ezingaphazamisa ukuphefumula.
• Lapho inhliziyo ingasebenzi kahle, igazi liqoqana ephashini eliphazamiseka ekusebenzeni kwalo kokuphefumula. I-edema yamaphaphu ibe seyakheka, futhi kungase kubonakale ubunzima bokuphefumula.
• I-Dyspnea ingenzeka ngesikhathi se-myocardial infarction; amandla enhliziyo okufinyela abe esencipha ngenxa ye-necrosis (= ukufa kwamangqamuzana) yengxenye yemisipha yenhliziyo ebangela isibazi enhliziyweni.
• Umfutho wegazi ophakeme udala ukwanda kokumelana nemithambo yamaphaphu okuholela ekuhlulekeni kwenhliziyo futhi kungenza ukuphefumula kube nzima.

Ukungaphatheki kahle okuthile okufana nempova noma ukungezwani nesikhunta noma ukukhuluphala (okugqugquzela indlela yokuphila unganyakazi) kungaba umthombo wokungakhululeki kokuphefumula.

Ukuphefumula kanzima nakho kungaba mnene futhi kubangelwe wukukhathazeka okukhulu. Lokhu kungenye yezimpawu zokuhlaselwa kokukhathazeka. Uma ungabaza, ungangabazi ukuxhumana nodokotela wakho. 

I-Dyspnea ingabangela ukuhluleka kwenhliziyo noma i-pneumothorax (= isifo se-pleura). Kungase futhi kubangele ukulimala kwengqondo uma ubuchopho bunganikezwa umoya-mpilo okwesikhashana.

Okubi nakakhulu, ukungakhululeki kokuphefumula kungaholela ekuboshweni kwenhliziyo ngoba kulokhu, umoya-mpilo awusajikelezi ngendlela efanele egazini uye enhliziyweni.

Okokuqala, kunconywa ukuphatha imbangela ye-dyspnea ukuze ikwazi ukuyidambisa noma ukuyimisa. Ukuze wenze lokhu, xhumana nodokotela wakho.

Ngemuva kwalokho, ukuvivinya umzimba njalo kungavumela ukuphefumula okungcono ngoba kuvimbela indlela yokuphila.

Ekugcineni, cabanga ukwenza i-aphoyintimenti nodokotela wakho ukuthola izifo ezingase zibe khona ezinjenge-pulmona emphysema, i-edema yamaphaphu noma nomfutho wegazi ophakeme ongaholela ku-dyspnea.