Chronic SOB

Question 1

Name 2 cardiac causes of chronic shortness of breath

Answer 1

Heart Failure
Aortic Stenosis

Question 2

Name 5 respiratory causes of chronic shortness of breath

Answer 2

Asthma
Recurrent pulmonary emboli
Lung cancer
Pulmonary fibrosis
Bronchiectasis

Question 3

Name 2 systemic causes of chronic shortness of breath

Answer 3

Anaemia
Obesity

Question 4

List 4 features suggestive of heart failure as the cause of chronic shortness of breath

Answer 4

Hx of IHD or HTN
Orthopnoea + PND

Left HF: Bibasal crackles + 3rd heart sound (S3)
Right HF: peripheral oedema + raised JVP

Question 5

List 3 features suggestive of aortic stenosis as the cause of chronic shortness of breath

Answer 5

Chest pain, SOB + syncope
Ejection systolic murmur radiating to the neck
Narrow pulse pressure

Question 6

List 3 features suggestive of asthma as the cause of chronic shortness of breath

Answer 6

Cough, wheeze + SOB
Sx often worse at night + may be precipitated by cold weather or exercise
a/w hay fever + eczema

Question 7

List 4 features suggestive of recurrent pulmonary emboli as the cause of chronic shortness of breath

Answer 7

Hx of predisposing factors e.g. Malignancy
Pleuritic chest pain + haemoptysis may be seen but Sx often vague
Tachycardia + tachypnoea in the acute situation
Sx of Right HF may develop in severe cases

Question 8

Give 2 features suggestive of bronchiectasis as the cause of chronic shortness of breath

Answer 8

Affected patients may produce large amounts of purulent sputum

Patients may have a hx of previous infections (e.g. TB, measles), bronchial obstruction or ciliary dyskinetic syndromes e.g. Kartagener’s syndrome

Question 9

List 3 features suggestive of lung cancer as the cause of chronic shortness of breath

Answer 9

Normally smokers
Haemoptysis, chronic cough or unresolving infection
Systemic Sx (FLAWS)

Question 10

List 3 features suggestive of pulmonary fibrosis as the cause of chronic shortness of breath

Answer 10

Progressive SOB may be only Sx
Fine bibasal crackles
Spirometry: restrictive pattern

Question 11

List 2 features suggestive of anaemia as the cause of chronic shortness of breath

Answer 11

Possible hx GI Sx
Pallor

Question 12

How can obesity cause chronic shortness of breath?

Answer 12

Due to increased work of activity