Cardinal Presentations
This post is part of a series called “Cardinal Presentations”, based on Rosen’s Emergency Medicine (8th edition).
Causes of Dyspnea
Findings in Selected Causes of Dyspnea
| Condition | History | Symptoms | Findings | Evaluation |
|---|---|---|---|---|
| Anaphylaxis | Exposure to allergen | Abrupt onset, facial swelling | Stridor, wheezing, hives | |
| PE | Immobilization, malignancy, prior DVT/PE, surgery, OCP | Abrupt onset, pleuritic chest pain | Tachycardia, hypoxia | ECG (RV strain) CT PA, D-dimer LE US (DVT) |
| Pneumonia | Exposure, tobacco use | Fever, productive cough | Focal rales | CXR CBC Blood/respiratory cultures |
| Pneumothorax | Trauma, thin male | Abrupt onset, chest pain | Decreased BS, subQ emphysema, JVD and tracheal deviation if tension | CXR US |
| Fluid overload | Dietary indiscretion, medication non-adherence | Orthopnea, PND | JVD, S3/S4, peripheral edema | CXR US ECG BNP |
| COPD/Asthma | Tobacco use, personal/family history | Progressive | Retractions, accessory muscle use, wheezing | CXR US (distinguish from fluid overload) |
| Malignancy | Tobacco use, weight loss | Hemoptysis | CXR CT Chest |
References
- Braithwaite, S., & Perina, D. (2013). Dyspnea. In Rosen’s Emergency Medicine – Concepts and Clinical Practice (8th ed., Vol. 1, pp. 206-213). Elsevier Health Sciences.