Pulmonology Book


Chronic Dyspnea

Aka: Chronic Dyspnea
  1. See Also
    1. Acute Dyspnea
    2. Dyspnea History
    3. Dyspnea Causes
    4. Dyspnea in Cancer
    5. Acute Respiratory Failure
  2. Definition: Chronic Dyspnea
    1. Subjective difficult or distressed breathing >1 month
  3. Causes
    1. See Dyspnea Causes
  4. History
    1. See Dyspnea History
  5. Exam
    1. See Dyspnea
  6. Management: Empiric Therapy to consider
    1. Bronchodilator trial for episodic Dyspnea
    2. Proton Pump Inhibitor if GERD suspected
  7. Approach: Step 1 Evaluation for Dyspnea >1 month
    1. Complete Blood Count
    2. Chemistry panel (e.g. chem8)
    3. Chest XRay
    4. Electrocardiogram
    5. Pulse Oximetry (while walking)
    6. Spirometry or Peak Flow
  8. Approach: Step 2 Evaluation (Indicated if negative Step 1)
    1. Complete Pulmonary Function Testing (PFT)
    2. Arterial Blood Gas (ABG)
    3. Brain Natriuretic Peptide (BNP)
    4. D-Dimer
    5. Chest CT (high resolution)
    6. Echocardiogram
    7. Holter Monitor
    8. Exercise Stress Test
  9. Approach: Step 3 Evaluation (Indicated if negative Step 2)
    1. Consider cardiology evaluation for angiography
    2. Consider pulmonology for bronchoscopy and biopsy
    3. Consider esophageal pH and manometry testing
  10. References
    1. Fangman in Noble (2001) Primary Care, p. 175-8
    2. Karnani (2005) Am Fam Physician 71(8):1529-37 [PubMed]
    3. Wahls (2012) Am Fam Physician 86(2): 173-80 [PubMed]

You are currently viewing the original 'fpnotebook.com\legacy' version of this website. Internet Explorer 8.0 and older will automatically be redirected to this legacy version.

If you are using a modern web browser, you may instead navigate to the newer desktop version of fpnotebook. Another, mobile version is also available which should function on both newer and older web browsers.

Please Contact Me as you run across problems with any of these versions on the website.

Navigation Tree