Dyspnoea + Wheeze Flashcards
What are the main causes of Dyspnoea
Lung dx Heart Dx obesity Functional hyperventilation (anxiety/panic attacks) anaemia
What is the most common cause of dyspnoea
Obstruction - asthma, COPD
What important Pulmonary causes of dyspnoea do you need to keep in mind?
Restrictive
Pulmonary Fibrosis
Collapse
pleural effusion
Obstructive:
Asthma
COPD
Name the different grades of dyspnoea according to the New York Heart Association
Grade 1 - no breathlessness
Grade 2 - Breathlessness on severe exertion
Grade 3 - Breathlessness on mild exertion
Grade 4 - Breathlessness at rest
What characteristics go dyspnoea from lung dx are there
Breathlessness at rest slow development of SOB Hx of Resp Dx Productive cough common Aggravated by Resp infection
What characteristics are there of Dyspnoea from heart dx
Hx of HTN, IHD, or valvular dx rapid development SOB mainly on exertion cough not common - if present then dry usually unaffected by resp infection
What is the name for an inspiratory wheeze?
Stridor
What are common causes of wheeze
Localised:
- partial bronchial obstruction
- -impacted FB
- impacted mucus plug
- extrinsic compression
Generalised:
- asthma
- obstructive bronchitis
- bronchiolitis
What symptoms would you expect in a “cardiac asthma” patient with wheeze?
SOB mainly inspiratory cough follows SOB sputum - pink and frothy relief - standing up, CPAP, diuretic, morphine Lumg signs - mainly crackles
What symptoms would you expect in Bronchial asthma
SOB mainly expiratory cough precedes SOB sputum - thick and gelatinous Relief - coughing up sputum, bronchodilator lung signs - mainly wheeze
What are the 6 most likely causes of SOB (in order)
Bronchial asthma Bronchiolitis (kids) COPD lack of fitness left heart failure obesity
which out of the 7 masquerades do not present as breathlessness
UTI
What other symptoms would you ex[ect with SOB caused by psychogenic causes
dizziness faintness palpitations yawning parasthesia of limbs inability to take a deep breath feeling like being smothered
In a pt with SOB what diseases are often missed as the cause?
Interstitial lung dx - fibrosing alveolitis, extrinisic allergic allveolitis, chemical pneumonitits metabolic acidosis radiotherapy kidney failure (uraemia) multiple small emboli
What serious RESPIRATORY disorders causing dyspnoea should not be missed
inhaled FB upper airways obstruction pneumothorax atelectasis pleural effusion TB
