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Chronic Dyspnea

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Chronic Dyspnea

  • Definition
  • Chronic Dyspnea
  1. Subjective difficult or distressed breathing >1 month
  • Causes
  • History
  • Exam
  1. See Dyspnea
  • Management
  • Empiric Therapy to consider
  1. Bronchodilator trial for episodic Dyspnea
  2. Proton Pump Inhibitor if GERD suspected
  • 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
  • Approach
  • Step 2 Evaluation (Indicated if negative Step 1)
  • 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