A Clinical Approach to Chronic Dyspnea

Abstract

Dyspnea is a common and important symptom. A small number of categories of disease cause the majority of cases, but the full differential diagnosis is vast. Given the large number of potential causes and the many possible diagnostic tests, an organized approach to the workup of dyspnea is crucial. This article outlines the spectrum of potential causes of dyspnea, the relative use of various diagnostic tests, and suggests a tiered approach to diagnosis.

An algorithmic approach to chronic dyspnea

“…The algorithm in the current study was based upon these earlier studies 2e4 and upon an exhaustive review of the literature on dyspnea. 5 We believe that it incorporates important prior findings into an organized approach.…”

“…the specific tests and sequence) was based upon the prior studies 2e4 as well as a review of the literature on causes of dyspnea. 5 It focused on the initial use of PFTs including BPC to diagnose Chronic Obstructive Pulmonary Disease (COPD) and asthma 4 the CXR to detect parenchymal lung and pleural disorders 4 and blood tests to detect anemia and heart failure. CPET followed when PFTs, CXR, and blood tests failed to detect or suggest a cause.…”