Differential Diagnosis of Dyspnea. Mixed cardiac and pulmonary disorders are also common sources of dyspnea6,7 and include COPD with pulmonary hypertension and cor pulmonale, deconditioning, pulmonary emboli and trauma. A plain chest x-ray can reveal pulmonary congestion, pneumothorax, or pneumonia. Specific blood tests called biomarkers also play an important role in the differential diagnosis of acute dyspnea.‎The definition of dyspnea · ‎Epidemiology · ‎Acute dyspnea · ‎The role of biomarkers. Jump to CONSTRUCTING A DIFFERENTIAL DIAGNOSIS - Heart disease, lung disease, and anemia are the most common causes of dyspnea.


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Evaluation of chronic dyspnea. Dyspnea Mechanisms, assessment, and management: Shiber JR, Santana J.

dyspnea differential diagnosis Med Clin North Am. Independent effect of depression and anxiety on chronic obstructive pulmonary disease exacerbations and hospitalizations. American College of Radiology. Sarkar S, Amelung PJ. Evaluation of the dyspneic patient in the office.

Chronic dyspnea—suspected pulmonary origin. Cause and evaluation of chronic dyspnea in a pulmonary disease clinic. Diagnosis of chronic obstructive pulmonary disease.


Attaining a correct diagnosis of COPD in general practice. Predicting risk of airflow obstruction in primary care: National Library of Medicine.

Thus, rapid evaluation and targeted diagnostic studies are of central importance. Overlapping clinical presentations and comorbid diseases, e.

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The presence of this symptom is already a predictor of increased mortality. Learning goals This article should enable the reader to: The search terms included the following, among others: The subjectivity of dyspnea is one of the main difficulties confronting the clinician whose task it is to determine the diagnosis and judge the severity of the underlying condition.

The pathogenesis of dyspnea is still not fully clear and is now under investigation. Current explanatory hypotheses are based on the concept of a regulatory circuit that consists of afferent information relayed centrally from chemoreceptors for pH, CO2, and O2as well as from mechanoreceptors in the musculature and the lungs [C fibers in the parenchyma, J fibers in dyspnea differential diagnosis bronchi and pulmonary vessels] and a corresponding ventilatory response dyspnea differential diagnosis.

To achieve maximal effort, the heart rate should reach at least 85 percent of the target heart rate for the patient's age.

Underlying heart disease may be signified by ST-segment changes, by arrhythmias or by inappropriate blood pressure changes during exercise. There are limitations to the sensitivity and specificity of treadmill testing, however, dyspnea differential diagnosis interpretation of the results may vary.

Causes and Evaluation of Chronic Dyspnea

Negative results on treadmill exercise testing in a patient who has dyspnea but no chest pain or other cardiac dyspnea differential diagnosis factors suggest that dyspnea is caused by something other than coronary artery disease.

When the results are equivocal or difficult to interpret, further diagnostic testing or consultation should be considered. Chamber size, hypertrophy and left ventricular ejection fraction can also be assessed.


A multigated cardiac acquisition MUGA scan or radionucleotide ventriculography can also be used to quantify the ejection fraction. Cardiopulmonary Exercise Testing Cardiopulmonary exercise testing quantifies cardiac function, pulmonary gas exchange, ventilation and physical fitness. Cardiopulmonary exercise testing may be used in selected cases when the diagnosis is still unclear after the inital examination.

It can be particularly useful in cases where obesity, anxiety, deconditioning, exercise-induced asthma or other dyspnea differential diagnosis preclude standard exercise dyspnea differential diagnosis testing.

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