DYSPNOEA-APPROACH

Inability to complete sentences in one breath implies severe breathlessness, differentials:

1. Wheezing? Differentials: asthma, COPD exacerbation, heart failure (cardiac asthma), anaphylaxis.

2. Stridor? Differentials: upper airway obstruction from foreign body or tumour, acute epiglottitis, anaphylaxis, trauma.

3. Crepitations? Differentials: heart failure, pneumonia, bronchiectasis, fibrosis.

4. Clear chest? Differentials: PE, hyperventilation, metabolic acidosis (diabetic ketoacidosis), anaemia, drugs (salicylates), shock ('air hunger'), CNS causes.

5. Pleural causes? Differentials: pneumothorax, pleural effusion.

6. Investigations: baseline obs, ABG, CXR, ECG, baseline bloods.

Reference(s)

Longmore, Murray; Wilkinson, Ian; Baldwin, Andrew; Wallin, Elizabeth. Oxford Handbook of Clinical Medicine - Mini Edition (Oxford Medical Handbooks) (p. 796). OUP Oxford. Kindle Edition.