Dyspnea Flashcards
What is dyspnea?
SUBJECTIVE complaint, abnormally increased awareness of breathing OR sensation of difficulty of breathing
2nd most common reason for ER visits in US
When taking a history, what is the FIRST question you need to ask for a pt w/ a CC of dyspnea?
HOW LONG HAS THIS BEEN GOING ON FOR???????
acute vs. chronic dyspnea is VERY IMPORTANT!
How does a slow progression of dyspnea differ from a rapid progression?
- Slow progression = likely to lead to a chronic etiology
- Rapid = likely to lead to an acute etiology and/or likely to coincide w/ alarm symptoms that may need immediate intervention
What are 10 possible associated symptoms?
- Chest pain
- Hemoptysis
- Fever
- Cough (productive vs. nonproductive)
- Wheezing
- Constitutional : fever, night sweats, weight loss, fatigue
- Itching/hives
- Edema
- Weight Loss
- Feeling of impending doom
What could chest pain indicate?
- Myocardial infarction…..(ask about radiation, description of pain)
- Pneumothorax
- Pulmonary embolism (can be unilateral or bilateral pleuritic pain too)
- Cardiac tamponade (central chest heaviness)
- Pericarditis (pleuritic pain radiating to the back w/ positional improvement)
- Pleuritic vs. cardiac
What could a FEVER indicate?
80% of pts. w/ pneumonia have fever
20% of pts. w/ PE have fever
What could a NON PRODUCTIVE cough indicate?
Asthma
Pulmonary embolism
GERD
What could a PRODUCTIVE cough indicate?
Acute Pneumonia
Flash pulmonary edema
COPD (chronic bronchitis)
What could WHEEZING indicate?
Asthma
COPD
Anaphylaxis
What could ITCHING/HIVES indicate?
Anaphylaxis
What could UNILATERAL EDEMA OF EXTREMITIES indicate?
DVT w/ PE
What could BILATERAL EDEMA OF EXTREMITIES indicate?
- Cardiomyopathy - more likely to have bilateral edema (DVT…unilateral)
- Pericardial disease
- Pulmonary Hypertension
What could WEIGHT LOSS indicate?
Cancer
What could a FEELING OF IMPENDING DOOM indicate?
Anxiety
MODIFIERS……Worse when LYING FLAT???
YES – ORTHOPNEA –> CHF
MODIFIERS…. Pain better when lay on one side or the other?
Trepopnea … occurs w/ unilateral effusions