Breathlessness

Objectives:
● List the red flags presentations of Breathlessness.
● Describe the approach to manage a patient with Breathlessness.
 Overview
Dyspnea is a nonspecific symptom of any disease involving the respiratory
system. diseases of many other organ systems (eg: neuromuscular, skeletal, renal,
endocrine, rheumatologic, hematologic, and psychiatric) may involve the
respiratory system and present with dyspnea.
 Red flags
Sudden onset: Pulmonary embolism or pneumothorax.

Severe intensity: Heart attack, severe asthma exacerbation, or pulmonary

edema.
Chest pain: Heart problem such as a heart attack or angina.

Palpitations or fainting: Arrhythmia or a sudden drop in blood pressure,

Coughing up blood: Pulmonary embolism, pneumonia, or lung cancer,

Recent travel: Pulmonary embolism, pneumonia, or altitude sickness.

Leg swelling: Heart failure or deep vein thrombosis

History of heart disease: Heart failure, angina, or heart attack

 Red flags
Risk factors for pulmonary embolism: Factors such as recent surgery, prolonged
immobility, history of blood clots, or use of oral contraceptives increase the risk of
pulmonary embolism, which can present with sudden breathlessness.
 Approach to manage a patient with
Breathlessness
Stable: Proceed with a focused history and physical examination.
Unstable: Signal impending respiratory failure such as confusion, inability to
speak in complete sentences, and the use of accessory respiratory muscles.

ABC assessment
● Diagnosis and treatment of underlying cause.
● Implementing lifestyle modifications such as smoking cessation or weight
management.
● Patient education and follow-up are essential components of care to optimize
long-term management and improve quality of life.
Summray:
Red flags:
• Sudden onset.
• Severe intensity.
• Chest pain.
• Palpitations or fainting.
• Coughing up blood.
• Recent travel.
• Leg swelling.
• History of heart disease.
• Dyspnea at rest.
• Inability to speak a complete sentence.
Summary:
 Reference :
● Sarkar, S., & Amelung, P. J. (2006). Evaluation of the dyspnoeic patient in
the office. Primary Care: Clinics in Office Practice, 33(3), 643-657.

● American family Physician

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Thank you