Common chest histories - Breathlessness Flashcards
What would you want to ask about breathlessness?
- Duration
- Onset - sudden/gradual
- Progression
- Timing - continuous/intermittent
- Normal vs current exercise tolerance
- Orthopnoea
- PND
- Diurnal/seasonal variation
What would you ask about systemically when asking about breathlessness?
- Fever, sweats
- Chest pain
- Palpitations
- Cough
- Sputum
- Haemoptysis
- Leg swelling
What features associated with breathlessness would indicate an MI?
- Acute onset SOB - often wakes them
- Associated nausea/sweatiness
- Crushing central chest pain
- CVS risk factors
What features associated with breathlessness would suggest heart failure?
- SOB
- Orthopnoea
- PND
- Pink frothy sputum if acute LVF
- Peripheral oedema
- Cardiac history
What features associated with breathlessness would suggest LRTI/pneumonia?
- ACute SOB
- Sough
- Sputum
- Systemic symptoms - fever
What features associated with breathlessness would suggest asthma as the cause?
- Intermittent wheeze
- Diurnal variation
- Nocturnal cough
- Exacerbating factors - exercise, pets
What features associated with breathlessness would suggest COPD as a cause?
- Chronic SOB
- Significant smoking history
- Chronic sputum production
What features associated with breathlesness would suggest a pneumothorax?
- Sudden onset pleuritic chest pain
- Risk factors - tall/thin, marfans, COPD/asthma
What features associated with breathessness would suggest PE?
- Pleuritic chest pain
- Haemoptysis
- Risk factors - immobility, malignancy, long haul flights, surgery
What features associated with breathlessness suggest pulmonary fibrosis?
- Progressive SOB over long period
- Dry cough
What are cardiac causes of breathlessness?
- MI
- Heart failure
- Aortic stenosis
What are respiratory causes of breathlessness?
- LRTI/pneumonia
- Asthma
- COPD
- Pneumothorax
- PE
- Pulmonary fibrosis
- Pleural effusion
- Bronchiectasis
- Lobar collapse
- Sarcoidosis/TB/extrinsicc alveolitis
What are are non-cardioresp causes of breathlessness?
- Anaemia
- Hyperventilation with anxiety
- DKA
- Neuromuscular causes
- Acidosis
