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Approach to the patient with dyspnea

INTRODUCTION

A consensus statement of the American Thoracic Society defined dyspnea in the following way [1]:

 "Dyspnea is a term used to characterize a subjective experience of breathing discomfort that is comprised of qualitatively distinct sensations that vary in intensity. The experience derives from interactions among multiple physiological, psychological, social, and environmental factors, and may induce secondary physiological and behavioral responses."

The American Thoracic Society (ATS) statement on the mechanisms, assessment, and management of dyspnea, as well as other ATS guidelines, can be accessed through the ATS web site at www.thoracic.org/statements.

Dyspnea, or breathing discomfort, is a common symptom that afflicts millions of patients with pulmonary disease and may be the primary manifestation of myocardial ischemia or dysfunction. Examination of the language of dyspnea suggests that this symptom represents a number of qualitatively distinct sensations, and that the words utilized by patients to describe their breathing discomfort may provide insight into the underlying pathophysiology of the disease.

The key elements in the evaluation of the patient with acute and chronic dyspnea will be reviewed here with a pathophysiologic construct to guide thinking about a differential diagnosis for the patient with dyspnea. The basic physiology of dyspnea is discussed separately. (See "Physiology of dyspnea".)

                         

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Literature review current through: Apr 2013. | This topic last updated: Sep 5, 2012.
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