This document provides guidance on managing acute exacerbations of shortness of breath (acute dyspnea). It outlines the common causes of acute dyspnea including pulmonary, cardiac, hematological, neuromuscular and other issues. The approach involves a focused physical exam assessing vital signs, chest, heart, extremities and mental status. It also discusses asking about the onset, associated symptoms and medical history to determine the underlying cause and directs on investigations and treating the identified cause.
3. Definition:
Subjective experience of breathing discomfort that
occurs over hours or days.
Acute Dyspnea is a common cause of:
Emergency department visits
Hospital Admissions
Decompensation among hospitalized patients
11. APPROACH TO THE PATIENT
Five keys areas of physical examination:
1. Vital Signs
2. Chest
3. Heart
4. Extremities
5. Mental Status
12. APPROACH TO THE PATIENT
Four Key Questions On patients History
1. What was the speed of onset?
2. What are the associated symptoms?
3. What occurred prior to onset of dyspnea?
4. What other medical Problems does the patient have?
13. HOW TO ASK ABOUT SHORTNESS OF
BREATH.?
CARDIAC SYMPTOMS
14. HOW TO ASK ABOUT SHORTNESS OF
BREATH.?
CHEST SYMPTOMS
15. HOW TO ASK ABOUT SHORTNESS OF
BREATH.?
ASSOCIATED SYMPTOMS
1. Nausea & Vomiting
2. Sweating.
3. Dizziness & Lightheadedness.
4. Constitutional (Toxic) Symptoms.
16. WHAT SHOULD I LOOK FOR IN A TARGETED
EXAMINATION?
1. Blood Pressure (on both sides)
2. Pulse (tachycardiac, Bradycardic, irregular)
3. Cardiac Auscultation (murmurs, pericadial rub)
4. Chest Auscultation (fine basal crepitations, coarse
crepitations, wheezes, reduced air entry)
17. DID I MISS SOMETHING IN EXAMINATION?
1. Pallor (may suggest that onemia or bleeding is the cause of dyspnea)
2. Fever (may suggests presence of pneumonia that cause
dyspnea)
3. Cyanosis (Usually suggests lung disease, but may occur in
severe hypoxia caused by APO)
