Monday, 25 July 2016

Approach to Dysnoea

Probability diagnosis

  • bronchial asthma
  • bronchioligitis (children)
  • COPD
  • Ageing; lack of fitness
  • Left heart failure
  • Obesity 
Serious disorders not to be missed
  • Cardiovascular
    • Acute heart failure
    • arrhythmia 
    • pulmonary embolism
    • fat embolism
    • pulmonary hypertension 
    • dissecting aneurysm 
    • cardiomyopathy
    • pericardial tamponade
    • anaphylaxis
  • Neoplasia
    • bronchial carncma, other malignancy
  • Severe infections
    • SARS
    • avian influenza
    • pneumonia
    • acute epiglottitis
  • Respiratory disorders
    • inhaled foreign body
    • upper airways obstruction 
    • pneumothorax
    • atelectasis
    • pleural effusion 
    • tuberculosis
    • acute respiratory distress syndrome
  • Neuromuscular disease
    • infective polyneuritis
    • poliomyelitis
Pitfalls
  • interstitial lung disease 
    • idiopathic pulmonary fibrosis 
    • extrinsic allergic alveolitis
    • sarcoidosis
  • chemical pneumonitis
  • metabolic acidosis 
  • radiotherapy 
  • kidney failure (uraemia)
  • multiple small pulmonary emboli
Severn masquerades checklist
  • Depression 
  • Diabetes
  • Drugs 
  • Anaemia 
  • Thyroid disorder 
  • Spinal dysfunction 
Is the patient trying to tell me something?
  • Consider functional hyperventilation 

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