SOB Differentials Flashcards
Pathophysiology of most presentations
Cardiopulmonary
Non cardiopulmonary
- anxiety, neurogenic causes => hyperventilation
- acidosis (DKA, AKI)
- impaired O2 delivery (sickle cell, CO poisoning)
- muscle weakness
Pattern of presentation
Circumstances - COVID, trauma
PHx - COPD, asthma, HF
Other symptoms - chest pain
Onset - acute, subacute
Common diagnoses
Asthma - past episodes, characteristic symptoms
COPD exacerbation - smoking Hx, chronic symptoms
HF - characteristic symptoms
Pneumonia - normally subacute
PE - non specific symptoms
PT - trauma
Blood loss - trauma, GI symptoms
Less common diagnoses
Arrythmias - AF can precipitate HF Pulmonary edema from non HF causes Upper airway obstruction Anemia CO poisoning Hemothorax Cardiac tamponade Non-cardiopulmonary -anxiety -acidosis -thyrotoxicosis -muscular weakness
Differentiating between HF and COPD
HF
- ankle swelling
- high JVP
- S3
- inspiratory creps
COPD
-sputum production
Investigations
Immediate assessment - Hx, exam, NEWS
O2 if hypoxic
Venous access
- FBC - anemia, infection
- U&E - renal function, electrolytes disturbance
- CRP
- routine bloods - LFTs, glucose
- Troponin, BNP, DD
ABG - esp in COPD
ECG
CXR
Specialised imaging - CTPA, echo (for pericardial effusion)
Common causes of chronic breathlessness
More lung based
- COPD
- asthma
- pulmonary fibrosis
- anemia
- pulmpnary HTN
MOST COMMON ACUTE PRESENTATIONS
ASTHMA
COPD
HF