Acute dyspnea: Difference between revisions
m (Rossdonaldson1 moved page Dyspnea to Shortness of breath over redirect) |
|||
| Line 2: | Line 2: | ||
==Diagnosis== | ==Diagnosis== | ||
[[File:PulmEdema.png|thumb|Pulmonary edema with small pleural effusions on both sides.]] | |||
===Emergent Pattern Recognition=== | ===Emergent Pattern Recognition=== | ||
#[[Pulmonary Edema]] | #[[Pulmonary Edema]] | ||
Revision as of 20:24, 24 March 2015
Background
Diagnosis
Emergent Pattern Recognition
- Pulmonary Edema
- lungs: b/l rales
- CXR: interstitial fluid
- Tx: ECG (R/O AMI), lasix, nitrates, ACE, BIPAP
- Bronchoconstriction
- lungs: wheezes
- CXR: neg/hyperinflated
- Tx: albuterol, atrovent, steroids, consider anaphylaxis (epi)
- Pneumonia
- lungs: focal ronchi/dec BS
- CXR: infiltrate/effusion
- Tx: abx
- PE
- lungs: clear
- CXR: clear/Westrmrk/Hmptn
- Tx: ECG, D-dimer and/or CT; anticoagulate/thrombolytics
- Pneumothorax/Hemothorax
- lungs: unequal
- CXR: pneumo/hemo
- Tx: needle/chest-tube
- Dysrythmia
- lungs: clear/pulm edema
- CXR: clear/pulm edema
- ECG: abnl
- Tx: rate dependent
- Cardiac Ischemia
- lungs: clear/pulm edema
- CXR: clear/pulm edema
- ECG: nl/abnl
- Tx: B-block, nitrates, anticoag, +/- thrombolytics
Differential Diagnosis
Acute dyspnea
Emergent
- Pulmonary
- Airway obstruction
- Anaphylaxis
- Angioedema
- Aspiration
- Asthma
- Cor pulmonale
- Inhalation exposure
- Noncardiogenic pulmonary edema
- Pneumonia
- Pneumocystis Pneumonia (PCP)
- Pulmonary embolism
- Pulmonary hypertension
- Tension pneumothorax
- Idiopathic pulmonary fibrosis acute exacerbation
- Cystic fibrosis exacerbation
- Cardiac
- Other Associated with Normal/↑ Respiratory Effort
- Other Associated with ↓ Respiratory Effort
Non-Emergent
- ALS
- Ascites
- Uncorrected ASD
- Congenital heart disease
- COPD exacerbation
- Fever
- Hyperventilation
- Interstitial lung disease
- Neoplasm
- Obesity
- Panic attack
- Pleural effusion
- Polymyositis
- Porphyria
- Pregnancy
- Rib fracture
- Spontaneous pneumothorax
- Thyroid Disease
- URI
Workup
- CXR
- ECG
- CBC
- Chem-7
- BNP?
- D-dimer?
- Troponin?
- ABG?
- Bedside ultrasound?
Treatment
- Oxygen
- Treat underlying cause
Source
- Rosen