Differential diagnosis
- Cardiac
- Heart failure – PND, orthopnoea, leg swelling
- Arrhythmia – palpitations, pre-syncope
- Valvular disease
- Pericardial disease
- Respiratory
- COPD – smoker, cough, progressive
- Asthma – atopy, wheeze
- PE
- Lung cancer
- Infection – Pneumonia, TB
- Bronchiectasis
- Asbestos lung disease
- Chest wall and diaphragm disease
- Lung fibrosis
- Other
- Obesity
- Anaemia
- Thyroid disease
- Physical deconditioning
- Anxiety
Data gathering
- Red flags – weight loss, haemoptysis, night sweats
- Others – triggers, impact, smoking, occupational risk factors, exercise
- Examine – Sats, Pulse, RR, BP, Chest, CVS, BMI, Peak flow
Clinical management
- Investigations
- Bloods – FBC, ferritin, U+Es, LFTs, TFTs, BNP
- CXR
- ECG
- Lung function testing
- Treatment
- Treat underlying cause
- Lifestyle – smoking cessation, increase exercise, weight loss
- Followup / Safety-net
Reference
https://www.enhertsccg.nhs.uk/sites/default/files/pathways/Breathlessness%20-%20Non-acute.pdf