Diaphragmatic paralysis differential diagnosis: Difference between revisions

Latest revision as of 21:22, 29 July 2020

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Mahda Alihashemi M.D. [2]

Overview

Unilateral diaphragmatic paralysis must be differentiated from eventration of the diaphragm. Eventration of the diaphragm is an abnormal elevation of the hemidiaphragm. Bilateral diaphragmatic paralysis must be differentiated from other diseases that cause elevation of the diaphragm such as pleural adhesions, subpulmonic effusions, obesity, ascites, abdominal organomegaly and ileus. Diaphragmatic paralysis must be differentiated from other disease that cause dyspnea such as dermatomyositis, polymyositis, rib fracture, pleural effusions, amyotrophic lateral sclerosis.

Differentiating diaphragmatic paralysis from other Diseases

Unilateral diaphragmatic paralysis must be differentiated from eventration of the diaphragm. Eventration of the diaphragm is an abnormal elevation of the hemidiaphragm that some parts of hemidiaphragm are replaced by fibrous tissue. Clinical manifestations of eventration of the diaphragm include asymptomatic, infection and respiratory distress.^[1]

Bilateral diaphragmatic paralysis must be differentiated from other diseases that cause elevation of the diaphragm such as:

Pleural adhesions
Subpulmonic effusions
Obesity with decreased chest wall compliance
Ascites
Abdominal organomegaly
Ileus

Diaphragmatic paralysis must be differentiated from other disease that cause dyspnea such as:

Abbreviations: ABG (arterial blood gas); ACE (angiotensin converting enzyme); BMI (body mass index); CBC (complete blood count); CSF (cerebrospinal fluid); CXR (chest X-ray); DOE (dyspnea on exercise); ECG (electrocardiogram); FEF (forced expiratory flow rate); FEV1 (forced expiratory volume); FVC (forced vital capacity); JVD (jugular vein distention); MCV (mean corpuscular volume); Plt (platelet); RV (residual volume); SIADH (syndrome of inappropriate antidiuretic hormone); TSH (thyroid stimulating hormone); Vt (tidal volume); WBC (white blood cell);

Organ system			Diseases	Clinical manifestations													Diagnosis					Other features
				Symptoms								Physical exam					Diagnosis
				Loss of consciousness	Agitation	Weight loss	Fever	Chest pain	Cough	Orthopnea	DOE	Cyanosis	Clubbing	JVD	Peripheral edema	Auscultation	CBC	ABG	Imaging	Spirometry	Gold standard
Acute Dyspnea	Respiratory system	Head and Neck, Upper airway	Aspiration^[2]	-	+	-	-	+/-	+	-	-	+	-	-	-	Diminished breath sounds	Normal	Normal	Atelectasis	↓Vt, ↑RV	Bronchoscopy	Choking
		Chest and Pleura, Lower airway	Atelectasis	-	-	-	+/-	+/-	+/-	-	-	+/-	-	-	-	Diminished breath sounds, Wheeze	Normal	↓O2, Normal/↓CO2	Collapsed lung lobe, fissuresdisplacement	↓ FVC	Chest CT scan	Surgical procedure, Aspiration, Mechanical ventilation
			Bronchitis^[3]	-	-	-	+	+	+	-	-	-	-	-	-	Rhonchi	↑WBC	Normal	Normal	Normal	Physical exam	Rhonchi relieved by cough
			Bronchiolitis^[4]	-	-	-	+	+/-	+	-	-	-	-	-	-	Wheeze and Crackles	↑WBC	Normal	Bronchovascular markings	↓Vt	Clinical assessment	Respiratory syncytial virus (RSV)
			Lung carcinoma^[5]	-	-	+	-	-	+	-	-	+	+	-	-	Wheeze and Crackles	Normal	Normal	Mass lesion, hilar lymphadenopathy	↓Vt, ↑RV	Bronchoscopy	Paraneoplastic syndromes, such as SIADH and lambert-Eaton
			Pneumonia^[6]	-	-	-	+	+	+	-	-	-	-	-	-	Wheeze, Rhonchi, and Crackles	↑WBC, neutrophilia	Normal	Lobar consolidation	Normal	Chest X-ray and CT Scan	productive cough
			Pneumothorax^[7]	-	-	-	-	+	-	-	-	-	-	+/-	-	Diminished breath sounds	Normal	↓O2, ↑CO2	Radiolucency without lung marking	↓Vt	CXR and Chest CT scan	Tracheal deviation
			Pulmonary embolism^[8]	-	-	-	-	+	-	-	+/-	-	-	-	-	Normal	Normal	Respiratory alkalosis	Normal	Normal	Pulmonary CT angiography	Pleuritic chest pain
			Rib fractures (flail chest)^[9]	-	+	-	-	+	-	-	-	-	-	-	-	Normal	Normal	Respiratory acidosis	Fracture marks	Normal	Chest X-ray	Pneumothorax
	Cardiovascular system		Pericardial tamponade^[10]	+/-	-	-	-	+	-	+/-	+/-	-	-	+	-	Muffled heart sounds	Normal	Normal	Water bottle appearance enlarged heart	Normal	Echocardiography	Fluid accumulation in pericardium
	Cardiovascular system		Pulmonary edema^[11]	+/-	+	-	+	+	+	+	+	+	+	+	+	Basal crackle	Normal	Respiratory alkalosis	Bat wing pattern, air bronchograms	↓Vt, ↑RV	Cardiac Catheterization	Tachypnea
	Central nervous system		Stroke	+	-	-	+/-	-	-	-	-	-	-	-	-	Normal	Normal	Normal	Intracranial infarct or hemorrhage	Normal	Brain MRI	Paralysis or paresthesia
			Encephalitis^[12]	+	+	-	+	-	-	-	-	-	-	-	-	Normal	↑WBC, neutrophilia	Normal	Normal	Normal	CSF PCR	Confusion
			Traumatic brain injury^[13]	+	+/-	-	-	-	-	-	-	-	-	-	-	Normal	Normal	Respiratory acidosis	Intracerebral hemorrhage	Normal	Brain CT scan	Lucid interval
Organ system			Diseases	Clinical manifestations													Diagnosis					Other features
				Symptoms								Physical exam					Diagnosis
				Loss of consciousness	Agitation	Weight loss	Fever	Chest pain	Cough	Orthopnea	DOE	Cyanosis	Clubbing	JVD	Peripheral edema	Auscultation	CBC	ABG	Imaging	Spirometry	Gold standard
Chronic Dyspnea	Respiratory system	Head and Neck, Upper airway	Goiter^[14]	-	-	-	-	-	-	-	-	-	-	-	+	Normal	Normal	Normal	Normal	Normal	Blood test (TSH, T4)	Weight gain
		Head and Neck, Upper airway	Laryngeal adenocarcinoma^[15]	-	-	+	-	-	+/-	-	-	-	-	-	-	Stridor	Normal	↓O2, ↑CO2	Retropharyngeal tissue thickness	Normal	Laryngoscopy	Choking sensation
		Chest and Pleura, Lower airway	COPD^[16]	-	-	+/-	-	-	+	+	+	+	+	+	+/-	Expiratory wheeze	↑ RBC	Respiratory alkalosis, Metabolic acidosis	↑ Bronchovascular markings, Cardiomegaly	↓ FEV1/FVC	Physical exam and Spirometry	Heavy smoking history
			Emphysema^[17]	-	-	-	-	-	+/-	-	-	+	+	-	-	Expiratory wheeze, Hyperinflation	Normal	Respiratory alkalosis, Metabolic acidosis	Flattening of diaphragm, vertical heart	↓ FEV1/FVC	Physical exam and Spirometry	Barrel chest
			Pulmonary hypertension^[18]	-	-	-	-	+/-	+/-	-	-	+/-	+/-	+	+	Accentuated S2	Normal	Hypoxia and acidosis	Enlarged pulmonary arteries	↑Physiologic RV	Cardiac catheterization	Syncope, Ascites, Pleural effusion
			Sarcoidosis^[19]	-	-	+/-	-	+/-	+	-	-	+	-	-	-	Crackles	Normal	↓O2, ↑CO2	Hilar adenopathy	↑ FEV1/FVC	High resolution computed tomography (HRCT)	Hypercalcemia, high ACE
			Pleural effusion^[20]	-	+/-	+	-	+	-	+/-	-	-	-	+/-	+/-	Egophony ("E-to-A" change)	Normal	Normal	Blunting of the costophrenic and cardiophrenic angle	↓Vt, ↑RV	Light's criteria	↓Tactile fremitus, Asymmetrical chest expansion
			Diaphragmatic paralysis^[21]	-	-	-	+/-	+/-	+/-	+	+	-	-	-	-	Normal	Normal	Normal	Unilateral or bilateral diaphragmatic flattening	↓Vt, ↑RV (anatomical)	CXR confirmed by fluoroscopic sniff test	Respiratory insufficiency
			Tuberculosis^[22]	-	-	+	+	+	+	-	-	+/-	-	-	-	Rhonchi, Wheezing, Crackles	↑WBC	↓O2, ↑CO2	Patchy consolidation or poorly defined linear and nodular opacities	Restrictive, obstructive, or mixed	IFN-γ release assay (IGRA) Acid-fast staining	Night sweat
	Cardiovascular system		Constrictive pericarditis^[10]	-	-	-	-	+	-	+	+	-	-	+	-	Muffled heart sounds	Normal	Normal	Calcifications	Normal	Chest CT scan	Syncope
	Cardiovascular system		Pericardial effusion^[23]	-	-	-	+/-	+	+	+/-	+/-	-	-	+	-	Muffled heart sounds	Normal	Normal	Fluid density around the heart	Normal	M-mode and 2-dimensional Doppler echocardiography	Hoarseness, Palpitation
	Neuromuscular disease		Amyotrophic lateral sclerosis^[24]	+/-	-	+/-	-	-	-	-	-	-	-	-	-	Normal	↑WBC	Normal	Normal	↓Vt, ↑RV	Revised El Escorial criteria (clinical)	Muscle weakness, Dysphagia
			Polymyositis/dermatomyositis^[25]	-	-	+/-	-	+	-	-	-	-	-	-	+/-	Normal	↑WBC	Normal	Normal	↓Vt, ↑RV	Muscle biopsy	Muscle weakness, Heliotrope
			Mitochondrial diseases^[26]	-	-	+/-	-	-	-	-	-	-	-	-	-	Wheeze	↓WBC, Plt	Normal	Normal	↓Vt, ↑RV	Muscle biopsy	Muscle pain
			Glycolytic enzyme defects (e.g., McArdle)^[27]	+/-	-	-	-	-	-	-	-	-	-	-	+/-	Normal	Normal	Normal	Normal	↓Vt, ↑RV	Muscle biopsy (ragged red fibers)	Myoglobinuria, Muscle weakness
	Systemic		Ascites^[28]	-	-	-	-	-	-	-	-	-	-	-	-	Normal	Normal	Normal	Peritoneal fluid accumulation	↓Vt, ↑RV	Abdominal ultrasound	Abdominal distention
			Kyphoscoliosis^[29]	-	-	-	-	-	-	-	-	-	-	-	-	Wheeze	Normal	Normal	Deviated vertebral column	↓Vt, ↑RV (anatomical)	Standing lateral spine radiograph	Low back pain
			Obesity^[30]	-	-	-	-	-	-	-	-	-	-	-	-	Normal	Normal	↓O2	Normal	↓Vt, ↑RV (anatomical)	BMI	Low stamina, Sweating

References

Template:WikiDoc Sources

↑ Ravisagar, Patel; Abhinav, Singh; Mathur, R.M.; Anula, Sisodia (2015). "Eventration of diaphragm presenting as recurrent respiratory tract infections – A case report". Egyptian Journal of Chest Diseases and Tuberculosis. 64 (1): 291–293. doi:10.1016/j.ejcdt.2014.10.002. ISSN 0422-7638.
↑ O'Horo JC, Rogus-Pulia N, Garcia-Arguello L, Robbins J, Safdar N (2015). "Bedside diagnosis of dysphagia: a systematic review". J Hosp Med. 10 (4): 256–65. doi:10.1002/jhm.2313. PMC 4607509. PMID 25581840.
↑ Cantin, Luce; Bankier, Alexander A.; Eisenberg, Ronald L. (2009). "Bronchiectasis". American Journal of Roentgenology. 193 (3): W158–W171. doi:10.2214/AJR.09.3053. ISSN 0361-803X.
↑ Holbro A, Lehmann T, Girsberger S, Stern M, Gambazzi F, Lardinois D, Heim D, Passweg JR, Tichelli A, Bubendorf L, Savic S, Hostettler K, Grendelmeier P, Halter JP, Tamm M (2013). "Lung histology predicts outcome of bronchiolitis obliterans syndrome after hematopoietic stem cell transplantation". Biol. Blood Marrow Transplant. 19 (6): 973–80. doi:10.1016/j.bbmt.2013.03.017. PMID 23562737.
↑ Dela Cruz CS, Tanoue LT, Matthay RA (2011). "Lung cancer: epidemiology, etiology, and prevention". Clin Chest Med. 32 (4): 605–44. doi:10.1016/j.ccm.2011.09.001. PMC 3864624. PMID 22054876.
↑ Simonetti AF, Viasus D, Garcia-Vidal C, Carratalà J (2014). "Management of community-acquired pneumonia in older adults". Ther Adv Infect Dis. 2 (1): 3–16. doi:10.1177/2049936113518041. PMC 4072047. PMID 25165554.
↑ Currie GP, Alluri R, Christie GL, Legge JS (2007). "Pneumothorax: an update". Postgrad Med J. 83 (981): 461–5. doi:10.1136/pgmj.2007.056978. PMC 2600088. PMID 17621614.
↑ Bĕlohlávek J, Dytrych V, Linhart A (2013). "Pulmonary embolism, part I: Epidemiology, risk factors and risk stratification, pathophysiology, clinical presentation, diagnosis and nonthrombotic pulmonary embolism". Exp Clin Cardiol. 18 (2): 129–38. PMC 3718593. PMID 23940438.
↑ Swart E, Laratta J, Slobogean G, Mehta S (February 2017). "Operative Treatment of Rib Fractures in Flail Chest Injuries: A Meta-analysis and Cost-Effectiveness Analysis". J Orthop Trauma. 31 (2): 64–70. doi:10.1097/BOT.0000000000000750. PMID 27984449.
↑ ^10.0 ^10.1 van Steijn JH, Sleijfer DT, van der Graaf WT, van der Sluis A, Nieboer P (2002). "How to diagnose cardiac tamponade". Neth J Med. 60 (8): 334–8. PMID 12481882.
↑ Martindale, Jennifer L.; Noble, Vicki E.; Liteplo, Andrew (2013). "Diagnosing pulmonary edema". European Journal of Emergency Medicine. 20 (5): 356–360. doi:10.1097/MEJ.0b013e32835c2b88. ISSN 0969-9546.
↑ Debiasi RL, Tyler KL (2004). "Molecular methods for diagnosis of viral encephalitis". Clin Microbiol Rev. 17 (4): 903–25, table of contents. doi:10.1128/CMR.17.4.903-925.2004. PMC 523566. PMID 15489354.
↑ McAllister TW (2011). "Neurobiological consequences of traumatic brain injury". Dialogues Clin Neurosci. 13 (3): 287–300. PMC 3182015. PMID 22033563.
↑ Stang MT, Armstrong MJ, Ogilvie JB, Yip L, McCoy KL, Faber CN, Carty SE (July 2012). "Positional dyspnea and tracheal compression as indications for goiter resection". Arch Surg. 147 (7): 621–6. doi:10.1001/archsurg.2012.96. PMID 22430090.
↑ Schwenk NR, Schapira RM, Byrd JC (November 1994). "Laryngeal carcinoma presenting as platypnea". Chest. 106 (5): 1609–11. PMID 7956433.
↑ Qureshi H, Sharafkhaneh A, Hanania NA (2014). "Chronic obstructive pulmonary disease exacerbations: latest evidence and clinical implications". Ther Adv Chronic Dis. 5 (5): 212–27. doi:10.1177/2040622314532862. PMC 4131503. PMID 25177479.
↑ Sharafkhaneh A, Hanania NA, Kim V (2008). "Pathogenesis of emphysema: from the bench to the bedside". Proc Am Thorac Soc. 5 (4): 475–7. doi:10.1513/pats.200708-126ET. PMC 2645322. PMID 18453358.
↑ Sajkov D, Petrovsky N, Palange P (June 2010). "Management of dyspnea in advanced pulmonary arterial hypertension". Curr Opin Support Palliat Care. 4 (2): 76–84. doi:10.1097/SPC.0b013e328338c1e0. PMID 20407377.
↑ Moher D, Cole CW, Hill GB (November 1992). "Epidemiology of abdominal aortic aneurysm: the effect of differing definitions". Eur J Vasc Surg. 6 (6): 647–50. PMID 1451823.
↑ Thomas R, Jenkins S, Eastwood PR, Lee YC, Singh B (July 2015). "Physiology of breathlessness associated with pleural effusions". Curr Opin Pulm Med. 21 (4): 338–45. doi:10.1097/MCP.0000000000000174. PMC 5633324. PMID 25978627.
↑ Dubé BP, Dres M (2016). "Diaphragm Dysfunction: Diagnostic Approaches and Management Strategies". J Clin Med. 5 (12). doi:10.3390/jcm5120113. PMC 5184786. PMID 27929389.
↑ Campbell IA, Bah-Sow O (2006). "Pulmonary tuberculosis: diagnosis and treatment". BMJ. 332 (7551): 1194–7. doi:10.1136/bmj.332.7551.1194. PMC 1463969. PMID 16709993.
↑ Jung HO (2012). "Pericardial effusion and pericardiocentesis: role of echocardiography". Korean Circ J. 42 (11): 725–34. doi:10.4070/kcj.2012.42.11.725. PMC 3518705. PMID 23236323.
↑ Lechtzin N, Lange DJ, Davey C, Becker B, Mitsumoto H (January 2007). "Measures of dyspnea in patients with amyotrophic lateral sclerosis". Muscle Nerve. 35 (1): 98–102. doi:10.1002/mus.20669. PMID 17029274.
↑ Schwarz MI, Matthay RA, Sahn SA, Stanford RE, Marmorstein BL, Scheinhorn DJ (January 1976). "Interstitial lung disease in polymyositis and dermatomyositis: analysis of six cases and review of the literature". Medicine (Baltimore). 55 (1): 89–104. PMID 1246203.
↑ Heinicke K, Taivassalo T, Wyrick P, Wood H, Babb TG, Haller RG (2011). "Exertional dyspnea in mitochondrial myopathy: clinical features and physiological mechanisms". Am J Physiol Regul Integr Comp Physiol. 301 (4): R873–84. doi:10.1152/ajpregu.00001.2011. PMC 3197343. PMID 21813873.
↑ Tarui S (1995). "Glycolytic defects in muscle: aspects of collaboration between basic science and clinical medicine". Muscle Nerve Suppl. 3: S2–9. PMID 7603522.
↑ Perri GA (2013). "Ascites in patients with cirrhosis". Can Fam Physician. 59 (12): 1297–9, e538–40. PMC 3860926. PMID 24336542.
↑ Qiabi M, Chagnon K, Beaupré A, Hercun J, Rakovich G (2015). "Scoliosis and bronchial obstruction". Can Respir J. 22 (4): 206–8. PMC 4530852. PMID 26083538.
↑ Sin DD, Jones RL, Man SF (July 2002). "Obesity is a risk factor for dyspnea but not for airflow obstruction". Arch. Intern. Med. 162 (13): 1477–81. PMID 12090884.

References

Template:WH Template:WS

[RavisagarAbhinav2015-1] Ravisagar, Patel; Abhinav, Singh; Mathur, R.M.; Anula, Sisodia (2015). "Eventration of diaphragm presenting as recurrent respiratory tract infections – A case report". Egyptian Journal of Chest Diseases and Tuberculosis. 64 (1): 291–293. doi:10.1016/j.ejcdt.2014.10.002. ISSN 0422-7638.

[pmid25581840-2] O'Horo JC, Rogus-Pulia N, Garcia-Arguello L, Robbins J, Safdar N (2015). "Bedside diagnosis of dysphagia: a systematic review". J Hosp Med. 10 (4): 256–65. doi:10.1002/jhm.2313. PMC 4607509. PMID 25581840.

[CantinBankier2009-3] Cantin, Luce; Bankier, Alexander A.; Eisenberg, Ronald L. (2009). "Bronchiectasis". American Journal of Roentgenology. 193 (3): W158–W171. doi:10.2214/AJR.09.3053. ISSN 0361-803X.

[pmid23562737-4] Holbro A, Lehmann T, Girsberger S, Stern M, Gambazzi F, Lardinois D, Heim D, Passweg JR, Tichelli A, Bubendorf L, Savic S, Hostettler K, Grendelmeier P, Halter JP, Tamm M (2013). "Lung histology predicts outcome of bronchiolitis obliterans syndrome after hematopoietic stem cell transplantation". Biol. Blood Marrow Transplant. 19 (6): 973–80. doi:10.1016/j.bbmt.2013.03.017. PMID 23562737.

[pmid22054876-5] Dela Cruz CS, Tanoue LT, Matthay RA (2011). "Lung cancer: epidemiology, etiology, and prevention". Clin Chest Med. 32 (4): 605–44. doi:10.1016/j.ccm.2011.09.001. PMC 3864624. PMID 22054876.

[pmid25165554-6] Simonetti AF, Viasus D, Garcia-Vidal C, Carratalà J (2014). "Management of community-acquired pneumonia in older adults". Ther Adv Infect Dis. 2 (1): 3–16. doi:10.1177/2049936113518041. PMC 4072047. PMID 25165554.

[pmid17621614-7] Currie GP, Alluri R, Christie GL, Legge JS (2007). "Pneumothorax: an update". Postgrad Med J. 83 (981): 461–5. doi:10.1136/pgmj.2007.056978. PMC 2600088. PMID 17621614.

[pmid23940438-8] Bĕlohlávek J, Dytrych V, Linhart A (2013). "Pulmonary embolism, part I: Epidemiology, risk factors and risk stratification, pathophysiology, clinical presentation, diagnosis and nonthrombotic pulmonary embolism". Exp Clin Cardiol. 18 (2): 129–38. PMC 3718593. PMID 23940438.

[pmid27984449-9] Swart E, Laratta J, Slobogean G, Mehta S (February 2017). "Operative Treatment of Rib Fractures in Flail Chest Injuries: A Meta-analysis and Cost-Effectiveness Analysis". J Orthop Trauma. 31 (2): 64–70. doi:10.1097/BOT.0000000000000750. PMID 27984449.

[pmid12481882-10] 10.0 ^10.1 van Steijn JH, Sleijfer DT, van der Graaf WT, van der Sluis A, Nieboer P (2002). "How to diagnose cardiac tamponade". Neth J Med. 60 (8): 334–8. PMID 12481882.

[MartindaleNoble2013-11] Martindale, Jennifer L.; Noble, Vicki E.; Liteplo, Andrew (2013). "Diagnosing pulmonary edema". European Journal of Emergency Medicine. 20 (5): 356–360. doi:10.1097/MEJ.0b013e32835c2b88. ISSN 0969-9546.

[pmid15489354-12] Debiasi RL, Tyler KL (2004). "Molecular methods for diagnosis of viral encephalitis". Clin Microbiol Rev. 17 (4): 903–25, table of contents. doi:10.1128/CMR.17.4.903-925.2004. PMC 523566. PMID 15489354.

[pmid22033563-13] McAllister TW (2011). "Neurobiological consequences of traumatic brain injury". Dialogues Clin Neurosci. 13 (3): 287–300. PMC 3182015. PMID 22033563.

[pmid22430090-14] Stang MT, Armstrong MJ, Ogilvie JB, Yip L, McCoy KL, Faber CN, Carty SE (July 2012). "Positional dyspnea and tracheal compression as indications for goiter resection". Arch Surg. 147 (7): 621–6. doi:10.1001/archsurg.2012.96. PMID 22430090.

[pmid7956433-15] Schwenk NR, Schapira RM, Byrd JC (November 1994). "Laryngeal carcinoma presenting as platypnea". Chest. 106 (5): 1609–11. PMID 7956433.

[pmid25177479-16] Qureshi H, Sharafkhaneh A, Hanania NA (2014). "Chronic obstructive pulmonary disease exacerbations: latest evidence and clinical implications". Ther Adv Chronic Dis. 5 (5): 212–27. doi:10.1177/2040622314532862. PMC 4131503. PMID 25177479.

[pmid18453358-17] Sharafkhaneh A, Hanania NA, Kim V (2008). "Pathogenesis of emphysema: from the bench to the bedside". Proc Am Thorac Soc. 5 (4): 475–7. doi:10.1513/pats.200708-126ET. PMC 2645322. PMID 18453358.

[pmid20407377-18] Sajkov D, Petrovsky N, Palange P (June 2010). "Management of dyspnea in advanced pulmonary arterial hypertension". Curr Opin Support Palliat Care. 4 (2): 76–84. doi:10.1097/SPC.0b013e328338c1e0. PMID 20407377.

[pmid14518232-19] Moher D, Cole CW, Hill GB (November 1992). "Epidemiology of abdominal aortic aneurysm: the effect of differing definitions". Eur J Vasc Surg. 6 (6): 647–50. PMID 1451823.

[pmid25978627-20] Thomas R, Jenkins S, Eastwood PR, Lee YC, Singh B (July 2015). "Physiology of breathlessness associated with pleural effusions". Curr Opin Pulm Med. 21 (4): 338–45. doi:10.1097/MCP.0000000000000174. PMC 5633324. PMID 25978627.

[pmid27929389-21] Dubé BP, Dres M (2016). "Diaphragm Dysfunction: Diagnostic Approaches and Management Strategies". J Clin Med. 5 (12). doi:10.3390/jcm5120113. PMC 5184786. PMID 27929389.

[pmid16709993-22] Campbell IA, Bah-Sow O (2006). "Pulmonary tuberculosis: diagnosis and treatment". BMJ. 332 (7551): 1194–7. doi:10.1136/bmj.332.7551.1194. PMC 1463969. PMID 16709993.

[pmid23236323-23] Jung HO (2012). "Pericardial effusion and pericardiocentesis: role of echocardiography". Korean Circ J. 42 (11): 725–34. doi:10.4070/kcj.2012.42.11.725. PMC 3518705. PMID 23236323.

[pmid17029274-24] Lechtzin N, Lange DJ, Davey C, Becker B, Mitsumoto H (January 2007). "Measures of dyspnea in patients with amyotrophic lateral sclerosis". Muscle Nerve. 35 (1): 98–102. doi:10.1002/mus.20669. PMID 17029274.

[pmid1246203-25] Schwarz MI, Matthay RA, Sahn SA, Stanford RE, Marmorstein BL, Scheinhorn DJ (January 1976). "Interstitial lung disease in polymyositis and dermatomyositis: analysis of six cases and review of the literature". Medicine (Baltimore). 55 (1): 89–104. PMID 1246203.

[pmid21813873-26] Heinicke K, Taivassalo T, Wyrick P, Wood H, Babb TG, Haller RG (2011). "Exertional dyspnea in mitochondrial myopathy: clinical features and physiological mechanisms". Am J Physiol Regul Integr Comp Physiol. 301 (4): R873–84. doi:10.1152/ajpregu.00001.2011. PMC 3197343. PMID 21813873.

[pmid7603522-27] Tarui S (1995). "Glycolytic defects in muscle: aspects of collaboration between basic science and clinical medicine". Muscle Nerve Suppl. 3: S2–9. PMID 7603522.

[pmid24336542-28] Perri GA (2013). "Ascites in patients with cirrhosis". Can Fam Physician. 59 (12): 1297–9, e538–40. PMC 3860926. PMID 24336542.

[pmid26083538-29] Qiabi M, Chagnon K, Beaupré A, Hercun J, Rakovich G (2015). "Scoliosis and bronchial obstruction". Can Respir J. 22 (4): 206–8. PMC 4530852. PMID 26083538.

[pmid12090884-30] Sin DD, Jones RL, Man SF (July 2002). "Obesity is a risk factor for dyspnea but not for airflow obstruction". Arch. Intern. Med. 162 (13): 1477–81. PMID 12090884.

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@@ Line 1: / Line 1: @@
 __NOTOC__
-{{Diaphragmatic paralysis}}
+[[Image:Home_logo1.png|right|250px|link=https://www.wikidoc.org/index.php/Diaphragmatic_paralysis]]
-{{CMG}}; {{AE}}
+{{CMG}}; {{AE}} {{MA}}
 ==Overview==
-[Disease name] must be differentiated from other diseases that cause [clinical feature 1], [clinical feature 2], and [clinical feature 3], such as [differential dx1], [differential dx2], and [differential dx3].
+Unilateral diaphragmatic paralysis must be differentiated from eventration of the [[diaphragm]]. Eventration of the diaphragm is an abnormal elevation of the  hemidiaphragm. [[Bilateral]] diaphragmatic paralysis must be differentiated from other diseases that cause elevation of the diaphragm such as pleural adhesions, subpulmonic effusions, [[obesity]], [[ascites]], abdominal organomegaly and [[ileus]]. Diaphragmatic paralysis must be differentiated from other disease that cause [[dyspnea]] such as [[dermatomyositis]], [[polymyositis]], [[rib fracture]], [[Pleural effusion|pleural effusions]], [[amyotrophic lateral sclerosis]].
-OR
+==Differentiating diaphragmatic paralysis from other Diseases  ==
+Unilateral diaphragmatic paralysis must be differentiated from eventration of the diaphragm. Eventration of the diaphragm is an abnormal elevation of the  hemidiaphragm that some parts of hemidiaphragm are replaced by [[fibrous tissue]].  Clinical manifestations of eventration of the [[diaphragm]] include [[asymptomatic]], [[infection]] and [[respiratory distress]].<ref name="RavisagarAbhinav2015">{{cite journal|last1=Ravisagar|first1=Patel|last2=Abhinav|first2=Singh|last3=Mathur|first3=R.M.|last4=Anula|first4=Sisodia|title=Eventration of diaphragm presenting as recurrent respiratory tract infections – A case report|journal=Egyptian Journal of Chest Diseases and Tuberculosis|volume=64|issue=1|year=2015|pages=291–293|issn=04227638|doi=10.1016/j.ejcdt.2014.10.002}}</ref>
-[Disease name] must be differentiated from [[differential dx1], [differential dx2], and [differential dx3].
+[[Bilateral]] diaphragmatic paralysis must be differentiated from other diseases that cause elevation of the diaphragm such as:
-==Differentiating diaphragmatic paralysis from other Diseases==
-Unilateral diaphragmatic paralysis must be diffrentiated from eventration of the diaphragm. Eventration of the diaphragam is an abnormal elevation of the  hemidiaphragm that some parts of hemidiaphragm are replaced by fibrous tissue.  Clinical manifetations of diaphragmatic paralysis  include asymptomatic, infection and respiratory distress.<ref name="RavisagarAbhinav2015" />
-Bilateral diaphragmatic paralysis must be differentiated from other diseases that cause elevation of the diaphragm such as
 * Pleural adhesions
 * Subpulmonic effusions
-* Obesity with decreased chest wall compliance
+* [[Obesity]] with decreased chest wall compliance
-* Ascites
+* [[Ascites]]
-* Abdominal organomegaly
+* [[Abdominal]] [[organomegaly]]
-* Ileus
+* [[Ileus]]
-The differential diagnosis of bilateral diaphragmatic elevation on the plain chest radiograph includes subpulmonic effusions, pleural adhesions, obesity with decreased chest wall and abdominal compliance, and subdiaphragmatic processes such as ascites, organomegaly, and ileus.<ref name="RavisagarAbhinav2015">{{cite journal|last1=Ravisagar|first1=Patel|last2=Abhinav|first2=Singh|last3=Mathur|first3=R.M.|last4=Anula|first4=Sisodia|title=Eventration of diaphragm presenting as recurrent respiratory tract infections – A case report|journal=Egyptian Journal of Chest Diseases and Tuberculosis|volume=64|issue=1|year=2015|pages=291–293|issn=04227638|doi=10.1016/j.ejcdt.2014.10.002}}</ref>
+'''Diaphragmatic paralysis must be differentiated from other disease that cause dyspnea such as:'''
-EVENTRATION OF THE DIAPHRAGM — Eventration of the diaphragm is a disorder in which all or part of the diaphragmatic muscle is replaced by fibroelastic tissue, leading to a thinned and pliable central portion of the diaphragm.
+<small>'''''Abbreviations:''''' '''ABG ('''[[arterial blood gas]]'''); ACE ('''[[Angiotensin-converting enzyme|angiotensin converting enzyme]]'''); BMI ('''[[body mass index]]'''); CBC ('''[[Complete blood counts|complete blood count]]'''); CSF ('''[[cerebrospinal fluid]]'''); CXR ('''[[chest X-ray]]'''); DOE ('''dyspnea on [[exercise]]'''); ECG ('''[[electrocardiogram]]'''); FEF ('''[[Spirometry|forced expiratory flow rate]]'''); FEV1 ('''[[forced expiratory volume]]'''); FVC ('''[[forced vital capacity]]'''); JVD ('''[[jugular vein distention]]''');''' '''MCV ('''[[mean corpuscular volume]]'''); Plt ('''[[platelet]]'''); RV ('''[[residual volume]]'''); SIADH ('''[[syndrome of inappropriate antidiuretic hormone]]'''); TSH ('''[[thyroid stimulating hormone]]'''); Vt ('''[[tidal volume]]''');''' '''WBC ('''[[White blood cells|white blood cell]]''');'''</small>
-Etiology — Eventration may be congenital or acquired; the congenital form reflects a failure of the fetal diaphragm to muscularize, whereas the acquired form is associated with phrenic nerve injury or is idiopathic [4,25]. The continuity of the diaphragm and normal attachments to the costal margin are maintained. (See "Eventration of the diaphragm in infants".)
-Clinical manifestations — In adults, diaphragmatic eventration is rarely symptomatic. When present, the symptoms associated with diaphragmatic eventration include dyspnea, palpitations, chest pain, dyspepsia, and recurrent pneumonia [26]. The degree of respiratory impairment ranges from the more common asymptomatic elevation of the diaphragmatic dome to the much less common degree of respiratory impairment seen in unilateral diaphragmatic paralysis. (See 'Clinical manifestations'above.)
-The severe congenital diaphragmatic eventration seen in newborns is discussed separately. (See "Eventration of the diaphragm in infants".)
-*[Disease name] must be differentiated from other diseases that cause [clinical feature 1], [clinical feature 2], and [clinical feature 3], such as [differential dx1], [differential dx2], and [differential dx3].
-*[Disease name] must be differentiated from [[differential dx1], [differential dx2], and [differential dx3].
-*As [disease name] manifests in a variety of clinical forms, differentiation must be established in accordance with the particular subtype. [Subtype name 1] must be differentiated from other diseases that cause [clinical feature 1], such as [differential dx1] and [differential dx2]. In contrast, [subtype name 2] must be differentiated from other diseases that cause [clinical feature 2], such as [differential dx3] and [differential dx4].
-===Preferred Table===
-{|
-|- style="background: #4479BA; color: #FFFFFF; text-align: center;"
-! rowspan="2" |Diseases
-! colspan="4" |History and Symptoms
-! colspan="4" |Physical Examination
-! colspan="4" |Laboratory Findings
-! rowspan="2" |Other Findings
-|- style="background: #4479BA; color: #FFFFFF; text-align: center;"
-!Finding
-!Finding 2
-!Finding 3
-!Finding
-!Physical Finding 1
-!Physical Finding 2
-!Physical Finding 3
-!Physical Finding 4
-!Lab Test 1
-!Lab Test 2
-!Lab Test 3
-!Lab Test 4
-|-
-| style="background: #DCDCDC; padding: 5px; text-align: center;" |Differential Diagnosis 1
-| style="background: #F5F5F5; padding: 5px;" |
-| style="background: #F5F5F5; padding: 5px;" |
-| style="background: #F5F5F5; padding: 5px;" |<nowiki>+</nowiki>
-| style="background: #F5F5F5; padding: 5px;" |
-| style="background: #F5F5F5; padding: 5px;" |
-| style="background: #F5F5F5; padding: 5px;" |
-| style="background: #F5F5F5; padding: 5px;" |
-| style="background: #F5F5F5; padding: 5px;" |
-| style="background: #F5F5F5; padding: 5px;" |
-| style="background: #F5F5F5; padding: 5px;" |
-| style="background: #F5F5F5; padding: 5px;" |
-| style="background: #F5F5F5; padding: 5px;" |
-| style="background: #F5F5F5; padding: 5px;" |
-|-
-| style="background: #DCDCDC; padding: 5px; text-align: center;" |Differential Diagnosis 2
-| style="background: #F5F5F5; padding: 5px;" |'''↑'''
-| style="background: #F5F5F5; padding: 5px;" |
-| style="background: #F5F5F5; padding: 5px;" |
-| style="background: #F5F5F5; padding: 5px;" | -
-| style="background: #F5F5F5; padding: 5px;" |
-| style="background: #F5F5F5; padding: 5px;" |
-| style="background: #F5F5F5; padding: 5px;" |
-| style="background: #F5F5F5; padding: 5px;" |
-| style="background: #F5F5F5; padding: 5px;" |
-| style="background: #F5F5F5; padding: 5px;" |
-| style="background: #F5F5F5; padding: 5px;" |
-| style="background: #F5F5F5; padding: 5px;" |
-| style="background: #F5F5F5; padding: 5px;" |
-|-
-| style="background: #DCDCDC; padding: 5px; text-align: center;" |Differential Diagnosis 3
-| style="background: #F5F5F5; padding: 5px;" |
-| style="background: #F5F5F5; padding: 5px;" |↓
-| style="background: #F5F5F5; padding: 5px;" |
-| style="background: #F5F5F5; padding: 5px;" |
-| style="background: #F5F5F5; padding: 5px;" |
-| style="background: #F5F5F5; padding: 5px;" |
-| style="background: #F5F5F5; padding: 5px;" |
-| style="background: #F5F5F5; padding: 5px;" |
-| style="background: #F5F5F5; padding: 5px;" |
-| style="background: #F5F5F5; padding: 5px;" |
-| style="background: #F5F5F5; padding: 5px;" |
-| style="background: #F5F5F5; padding: 5px;" |
-| style="background: #F5F5F5; padding: 5px;" |
-|-
-| style="background: #DCDCDC; padding: 5px; text-align: center;" |Differential Diagnosis 4
-| style="background: #F5F5F5; padding: 5px;" |
-| style="background: #F5F5F5; padding: 5px;" |
-| style="background: #F5F5F5; padding: 5px;" |
-| style="background: #F5F5F5; padding: 5px;" |
-| style="background: #F5F5F5; padding: 5px;" |
-| style="background: #F5F5F5; padding: 5px;" |
-| style="background: #F5F5F5; padding: 5px;" |
-| style="background: #F5F5F5; padding: 5px;" |
-| style="background: #F5F5F5; padding: 5px;" |
-| style="background: #F5F5F5; padding: 5px;" |
-| style="background: #F5F5F5; padding: 5px;" |
-| style="background: #F5F5F5; padding: 5px;" |
-| style="background: #F5F5F5; padding: 5px;" |
-|-
-| style="background: #DCDCDC; padding: 5px; text-align: center;" |Differential Diagnosis 5
-| style="background: #F5F5F5; padding: 5px;" |
-| style="background: #F5F5F5; padding: 5px;" |
-| style="background: #F5F5F5; padding: 5px;" |
-| style="background: #F5F5F5; padding: 5px;" |
-| style="background: #F5F5F5; padding: 5px;" |
-| style="background: #F5F5F5; padding: 5px;" |
-| style="background: #F5F5F5; padding: 5px;" |
-| style="background: #F5F5F5; padding: 5px;" |
-| style="background: #F5F5F5; padding: 5px;" |
-| style="background: #F5F5F5; padding: 5px;" |
-| style="background: #F5F5F5; padding: 5px;" |
-| style="background: #F5F5F5; padding: 5px;" |
-| style="background: #F5F5F5; padding: 5px;" |
-|}
-===Use if the above table can not be made===
-{| style="border: 0px; font-size: 90%; margin: 3px; width: 1000px" align="center"
-| valign="top" |
-|+
-! style="background: #4479BA; width: 200px;" | {{fontcolor|#FFF|Differential Diagnosis}}
-! style="background: #4479BA; width: 300px;" | {{fontcolor|#FFF|Similar Features}}
-! style="background: #4479BA; width: 300px;" | {{fontcolor|#FFF|Differentiating Features}}
-|-
-| style="padding: 5px 5px; background: #DCDCDC; font-weight: bold; text-align:center;" |Differential 1
-| style="padding: 5px 5px; background: #F5F5F5;" |
-* On [physical exam; history; diagnostic test; imaging], [Differential 1] {has; demonstrates} [feature 1], [feature 2], [feature 3] also observed in [disease name].
-| style="padding: 5px 5px; background: #F5F5F5;" |
-* On [physical exam; history; diagnostic test; imaging], [Differential 1] {has; demonstrates} [feature 1], [feature 2], [feature 3] that distinguish it from [disease name].
-|-
-| style="padding: 5px 5px; background: #DCDCDC; font-weight: bold; text-align:center;" |Differential 2
-| style="padding: 5px 5px; background: #F5F5F5;" |
-* On [physical exam; history; diagnostic test; imaging], [Differential 1] {has; demonstrates} [feature 1], [feature 2], [feature 3] also observed in [disease name].
-| style="padding: 5px 5px; background: #F5F5F5;" |
-* On [physical exam; history; diagnostic test; imaging], [Differential 1] {has; demonstrates} [feature 1], [feature 2], [feature 3] that distinguish it from [disease name].
-|-
-| style="padding: 5px 5px; background: #DCDCDC; font-weight: bold; text-align:center;" |Differential 3
-| style="padding: 5px 5px; background: #F5F5F5;" |
-* On [physical exam; history; diagnostic test; imaging], [Differential 1] {has; demonstrates} [feature 1], [feature 2], [feature 3] also observed in [disease name].
-| style="padding: 5px 5px; background: #F5F5F5;" |
-* On [physical exam; history; diagnostic test; imaging], [Differential 1] {has; demonstrates} [feature 1], [feature 2], [feature 3] that distinguish it from [disease name].
-|-
-| style="padding: 5px 5px; background: #DCDCDC; font-weight: bold; text-align:center;" |Differential 4
-| style="padding: 5px 5px; background: #F5F5F5;" |
-* On [physical exam; history; diagnostic test; imaging], [Differential 1] {has; demonstrates} [feature 1], [feature 2], [feature 3] also observed in [disease name].
-| style="padding: 5px 5px; background: #F5F5F5;" |
-* On [physical exam; history; diagnostic test; imaging], [Differential 1] {has; demonstrates} [feature 1], [feature 2], [feature 3] that distinguish it from [disease name].
-|-
-| style="padding: 5px 5px; background: #DCDCDC; font-weight: bold; text-align:center;" |Differential 5
-| style="padding: 5px 5px; background: #F5F5F5;" |
-* On [physical exam; history; diagnostic test; imaging], [Differential 1] {has; demonstrates} [feature 1], [feature 2], [feature 3] also observed in [disease name].
-| style="padding: 5px 5px; background: #F5F5F5;" |
-* On [physical exam; history; diagnostic test; imaging], [Differential 1] {has; demonstrates} [feature 1], [feature 2], [feature 3] that distinguish it from [disease name].
-|}
-<small>'''''Abbreviations:''''' '''ABG ('''[[arterial blood gas]]'''); ACE ('''[[Angiotensin-converting enzyme|angiotensin converting enzyme]]'''); BMI ('''[[body mass index]]'''); CBC ('''[[Complete blood counts|complete blood count]]'''); CSF ('''[[cerebrospinal fluid]]'''); CXR ('''[[chest X-ray]]'''); DOE ('''dyspnea on [[exercise]]'''); ECG ('''[[electrocardiogram]]'''); FEF ('''[[Spirometry|forced expiratory flow rate]]'''); FEV1 ('''[[forced expiratory volume]]'''); FVC ('''[[forced vital capacity]]'''); JVD ('''[[jugular vein distention]]''');''' '''MCV ('''[[mean corpuscular volume]]'''); Plt ('''[[platelet]]'''); RV ('''[[residual volume]]'''); SIADH ('''[[syndrome of inappropriate antidiuretic hormone]]'''); TSH ('''[[thyroid stimulating hormone]]'''); Vt ('''[[tidal volume]]''');''' '''WBC ('''[[White blood cells|white blood cell]]''');'''</small>
 <small><small>
 {|
 |- style="background: #4479BA; color: #FFFFFF; text-align: center;"
@@ Line 206: / Line 51: @@
 !Gold standard
 |- style="background: #DCDCDC; padding: 5px; text-align: center;" |
-! rowspan="33" |Acute Dyspnea
+! rowspan="14" |Acute Dyspnea
-! rowspan="18" |[[Respiratory system]]
+! rowspan="9" |[[Respiratory system]]
-! rowspan="7" |[[Head]] and [[Neck]],
+![[Head]] and [[Neck]],
 Upper [[airway]]
-![[Angioedema]]<ref name="pmid28405953">{{cite journal| author=Bernstein JA, Cremonesi P, Hoffmann TK, Hollingsworth J| title=Angioedema in the emergency department: a practical guide to differential diagnosis and management. | journal=Int J Emerg Med | year= 2017 | volume= 10 | issue= 1 | pages= 15 | pmid=28405953 | doi=10.1186/s12245-017-0141-z | pmc=5389952 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=28405953  }}</ref>
-! style="background: #F5F5F5; padding: 5px;" |-
-! style="background: #F5F5F5; padding: 5px;" |-
-! style="background: #F5F5F5; padding: 5px;" |-
-! style="background: #F5F5F5; padding: 5px;" |-
-! style="background: #F5F5F5; padding: 5px;" |-
-! style="background: #F5F5F5; padding: 5px;" |+/-
-! style="background: #F5F5F5; padding: 5px;" |+
-! style="background: #F5F5F5; padding: 5px;" |-
-! style="background: #F5F5F5; padding: 5px;" |-
-! style="background: #F5F5F5; padding: 5px;" |+/-
-! style="background: #F5F5F5; padding: 5px;" |-
-! style="background: #F5F5F5; padding: 5px;" |+
-! style="background: #F5F5F5; padding: 5px;" |Normal
-! style="background: #F5F5F5; padding: 5px;" |Normal
-! style="background: #F5F5F5; padding: 5px;" |↓[[Oxygen|O2]], ↑[[CO2]]
-! style="background: #F5F5F5; padding: 5px;" |Normal
-! style="background: #F5F5F5; padding: 5px;" |N/A
-! style="background: #F5F5F5; padding: 5px;" |[[Physical examination|Physical exam]]
-! style="background: #F5F5F5; padding: 5px;" |[[Generalized edema]]
-|- style="background: #DCDCDC; padding: 5px; text-align: center;" |
-![[Anaphylaxis]]<ref name="pmid21293765">{{cite journal| author=Bjornsson HM, Graffeo CS| title=Improving diagnostic accuracy of anaphylaxis in the acute care setting. | journal=West J Emerg Med | year= 2010 | volume= 11 | issue= 5 | pages= 456-61 | pmid=21293765 | doi= | pmc=3027438 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=21293765  }}</ref>
-! style="background: #F5F5F5; padding: 5px;" |+/-
-! style="background: #F5F5F5; padding: 5px;" |+
-! style="background: #F5F5F5; padding: 5px;" |-
-! style="background: #F5F5F5; padding: 5px;" |+/-
-! style="background: #F5F5F5; padding: 5px;" |-
-! style="background: #F5F5F5; padding: 5px;" |-
-! style="background: #F5F5F5; padding: 5px;" |-
-! style="background: #F5F5F5; padding: 5px;" |-
-! style="background: #F5F5F5; padding: 5px;" |+/-
-! style="background: #F5F5F5; padding: 5px;" |-
-! style="background: #F5F5F5; padding: 5px;" |-
-! style="background: #F5F5F5; padding: 5px;" |-
-! style="background: #F5F5F5; padding: 5px;" |Scattered [[wheezing]]
-! style="background: #F5F5F5; padding: 5px;" |Normal
-! style="background: #F5F5F5; padding: 5px;" |Normal
-! style="background: #F5F5F5; padding: 5px;" |Normal
-! style="background: #F5F5F5; padding: 5px;" |N/A
-! style="background: #F5F5F5; padding: 5px;" |[[Vital sign]]
-! style="background: #F5F5F5; padding: 5px;" |[[Type 1 hypersensitivity]]
-|- style="background: #DCDCDC; padding: 5px; text-align: center;" |
 ![[Aspiration]]<ref name="pmid25581840">{{cite journal| author=O'Horo JC, Rogus-Pulia N, Garcia-Arguello L, Robbins J, Safdar N| title=Bedside diagnosis of dysphagia: a systematic review. | journal=J Hosp Med | year= 2015 | volume= 10 | issue= 4 | pages= 256-65 | pmid=25581840 | doi=10.1002/jhm.2313 | pmc=4607509 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=25581840  }}</ref>
 ! style="background: #F5F5F5; padding: 5px;" |-
@@ Line 273: / Line 76: @@
 ! style="background: #F5F5F5; padding: 5px;" |[[Choking]]
 |- style="background: #DCDCDC; padding: 5px; text-align: center;" |
-![[Croup]]<ref name="pmid23939212">{{cite journal| author=Bjornson CL, Johnson DW| title=Croup in children. | journal=CMAJ | year= 2013 | volume= 185 | issue= 15 | pages= 1317-23 | pmid=23939212 | doi=10.1503/cmaj.121645 | pmc=3796596 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=23939212  }}</ref>
+! rowspan="8" |[[Chest]] and [[Pleurae|Pleura]],
-! style="background: #F5F5F5; padding: 5px;" |-
-! style="background: #F5F5F5; padding: 5px;" |+
-! style="background: #F5F5F5; padding: 5px;" |-
-! style="background: #F5F5F5; padding: 5px;" |+/-
-! style="background: #F5F5F5; padding: 5px;" |-
-! style="background: #F5F5F5; padding: 5px;" |+
-! style="background: #F5F5F5; padding: 5px;" |-
-! style="background: #F5F5F5; padding: 5px;" |-
-! style="background: #F5F5F5; padding: 5px;" |+
-! style="background: #F5F5F5; padding: 5px;" |-
-! style="background: #F5F5F5; padding: 5px;" |-
-! style="background: #F5F5F5; padding: 5px;" |-
-! style="background: #F5F5F5; padding: 5px;" |[[Stridor]]
-! style="background: #F5F5F5; padding: 5px;" |↑[[WBC]]
-! style="background: #F5F5F5; padding: 5px;" |Normal
-! style="background: #F5F5F5; padding: 5px;" |[[Steeple sign]]
-! style="background: #F5F5F5; padding: 5px;" |Normal
-! style="background: #F5F5F5; padding: 5px;" |[[Physical examination|Physical exam]]
-! style="background: #F5F5F5; padding: 5px;" |[[Barking cough]]
-|- style="background: #DCDCDC; padding: 5px; text-align: center;" |
-![[Epiglottitis]]<ref name="pmid17104162">{{cite journal| author=Negus VE| title=The Function of the Epiglottis. | journal=J Anat | year= 1927 | volume= 62 | issue= Pt 1 | pages= 1-8 | pmid=17104162 | doi= | pmc=1250045 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=17104162  }}</ref>
-! style="background: #F5F5F5; padding: 5px;" |-
-! style="background: #F5F5F5; padding: 5px;" |+
-! style="background: #F5F5F5; padding: 5px;" |-
-! style="background: #F5F5F5; padding: 5px;" |+
-! style="background: #F5F5F5; padding: 5px;" |-
-! style="background: #F5F5F5; padding: 5px;" |+
-! style="background: #F5F5F5; padding: 5px;" |-
-! style="background: #F5F5F5; padding: 5px;" |-
-! style="background: #F5F5F5; padding: 5px;" |-
-! style="background: #F5F5F5; padding: 5px;" |-
-! style="background: #F5F5F5; padding: 5px;" |-
-! style="background: #F5F5F5; padding: 5px;" |-
-! style="background: #F5F5F5; padding: 5px;" |[[Stridor]]
-! style="background: #F5F5F5; padding: 5px;" |↑[[WBC]]
-! style="background: #F5F5F5; padding: 5px;" |Normal
-! style="background: #F5F5F5; padding: 5px;" |[[Thumbprint sign|Thumb sign]]
-! style="background: #F5F5F5; padding: 5px;" |Normal
-! style="background: #F5F5F5; padding: 5px;" |[[Laryngoscopy]]
-! style="background: #F5F5F5; padding: 5px;" |[[Drooling]]
-|- style="background: #DCDCDC; padding: 5px; text-align: center;" |
-![[Rhinosinusitis]]<ref name="pmid214901812">{{cite journal| author=Meltzer EO, Hamilos DL| title=Rhinosinusitis diagnosis and management for the clinician: a synopsis of recent consensus guidelines. | journal=Mayo Clin Proc | year= 2011 | volume= 86 | issue= 5 | pages= 427-43 | pmid=21490181 | doi=10.4065/mcp.2010.0392 | pmc=3084646 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=21490181  }}</ref>
-! style="background: #F5F5F5; padding: 5px;" |-
-! style="background: #F5F5F5; padding: 5px;" |-
-! style="background: #F5F5F5; padding: 5px;" |-
-! style="background: #F5F5F5; padding: 5px;" |+
-! style="background: #F5F5F5; padding: 5px;" |-
-! style="background: #F5F5F5; padding: 5px;" |+/-
-! style="background: #F5F5F5; padding: 5px;" |-
-! style="background: #F5F5F5; padding: 5px;" |-
-! style="background: #F5F5F5; padding: 5px;" |-
-! style="background: #F5F5F5; padding: 5px;" |-
-! style="background: #F5F5F5; padding: 5px;" |-
-! style="background: #F5F5F5; padding: 5px;" |-
-! style="background: #F5F5F5; padding: 5px;" |Normal
-! style="background: #F5F5F5; padding: 5px;" |↑[[WBC]]
-! style="background: #F5F5F5; padding: 5px;" |Normal
-! style="background: #F5F5F5; padding: 5px;" |Air fluid level
-! style="background: #F5F5F5; padding: 5px;" |Normal
-! style="background: #F5F5F5; padding: 5px;" |[[Physical examination|Physical exam]]
-! style="background: #F5F5F5; padding: 5px;" |[[Headache]]
-|- style="background: #DCDCDC; padding: 5px; text-align: center;" |
-![[Vocal cord paralysis|Vocal cord dysfunction]]<ref name="pmid8828523">{{cite journal |vauthors=Wood RP, Milgrom H |title=Vocal cord dysfunction |journal=J. Allergy Clin. Immunol. |volume=98 |issue=3 |pages=481–5 |date=September 1996 |pmid=8828523 |doi= |url= |author=}}</ref>
-! style="background: #F5F5F5; padding: 5px;" |-
-! style="background: #F5F5F5; padding: 5px;" |-
-! style="background: #F5F5F5; padding: 5px;" |-
-! style="background: #F5F5F5; padding: 5px;" |-
-! style="background: #F5F5F5; padding: 5px;" |-
-! style="background: #F5F5F5; padding: 5px;" |+/-
-! style="background: #F5F5F5; padding: 5px;" |-
-! style="background: #F5F5F5; padding: 5px;" |-
-! style="background: #F5F5F5; padding: 5px;" |-
-! style="background: #F5F5F5; padding: 5px;" |-
-! style="background: #F5F5F5; padding: 5px;" |-
-! style="background: #F5F5F5; padding: 5px;" |-
-! style="background: #F5F5F5; padding: 5px;" |[[Stridor]]
-! style="background: #F5F5F5; padding: 5px;" |Normal
-! style="background: #F5F5F5; padding: 5px;" |Normal
-! style="background: #F5F5F5; padding: 5px;" |Normal
-! style="background: #F5F5F5; padding: 5px;" |↓ [[FVC]]
-! style="background: #F5F5F5; padding: 5px;" |[[Laryngoscopy]]
-! style="background: #F5F5F5; padding: 5px;" |[[Choking]] sensation
-|- style="background: #DCDCDC; padding: 5px; text-align: center;" |
-! rowspan="11" |[[Chest]] and [[Pleurae|Pleura]],
 Lower [[airway]]
-![[Asthma attack]]<ref name="pmid19858243">{{cite journal| author=Hodder R, Lougheed MD, Rowe BH, FitzGerald JM, Kaplan AG, McIvor RA| title=Management of acute asthma in adults in the emergency department: nonventilatory management. | journal=CMAJ | year= 2010 | volume= 182 | issue= 2 | pages= E55-67 | pmid=19858243 | doi=10.1503/cmaj.080072 | pmc=2817338 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=19858243  }}</ref>
-! style="background: #F5F5F5; padding: 5px;" |-
-! style="background: #F5F5F5; padding: 5px;" |+
-! style="background: #F5F5F5; padding: 5px;" |-
-! style="background: #F5F5F5; padding: 5px;" |-
-! style="background: #F5F5F5; padding: 5px;" |+/-
-! style="background: #F5F5F5; padding: 5px;" |+
-! style="background: #F5F5F5; padding: 5px;" |-
-! style="background: #F5F5F5; padding: 5px;" |-
-! style="background: #F5F5F5; padding: 5px;" |+
-! style="background: #F5F5F5; padding: 5px;" |-
-! style="background: #F5F5F5; padding: 5px;" |-
-! style="background: #F5F5F5; padding: 5px;" |-
-! style="background: #F5F5F5; padding: 5px;" |[[Wheeze]]
-! style="background: #F5F5F5; padding: 5px;" |↑ [[Eosinophil]]
-! style="background: #F5F5F5; padding: 5px;" |[[Respiratory alkalosis]]
-! style="background: #F5F5F5; padding: 5px;" |Normal
-! style="background: #F5F5F5; padding: 5px;" |↓ [[FEV1]], [[Peak expiratory flow|PEF]]
-! style="background: #F5F5F5; padding: 5px;" |[[Physical examination|Physical exam]] and
-[[Spirometry]]
-! style="background: #F5F5F5; padding: 5px;" |[[Chest pain]]
-|- style="background: #DCDCDC; padding: 5px; text-align: center;" |
 !'''[[Atelectasis]]'''
 ! style="background: #F5F5F5; padding: 5px;" |-
@@ Line 423: / Line 120: @@
 ! style="background: #F5F5F5; padding: 5px;" |[[Physical examination|Physical exam]]
 ! style="background: #F5F5F5; padding: 5px;" |[[Rhonchi]] relieved by [[Dextromethorphan|cough]]
-|- style="background: #DCDCDC; padding: 5px; text-align: center;" |
-![[Bronchospasm]]<ref name="pmid23015953">{{cite journal| author=Molis MA, Molis WE| title=Exercise-induced bronchospasm. | journal=Sports Health | year= 2010 | volume= 2 | issue= 4 | pages= 311-7 | pmid=23015953 | doi=10.1177/1941738110373735 | pmc=3445098 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=23015953  }}</ref>
-! style="background: #F5F5F5; padding: 5px;" |+/-
-! style="background: #F5F5F5; padding: 5px;" |+
-! style="background: #F5F5F5; padding: 5px;" |-
-! style="background: #F5F5F5; padding: 5px;" |-
-! style="background: #F5F5F5; padding: 5px;" |+
-! style="background: #F5F5F5; padding: 5px;" |+/-
-! style="background: #F5F5F5; padding: 5px;" |-
-! style="background: #F5F5F5; padding: 5px;" |-
-! style="background: #F5F5F5; padding: 5px;" |+
-! style="background: #F5F5F5; padding: 5px;" |-
-! style="background: #F5F5F5; padding: 5px;" |-
-! style="background: #F5F5F5; padding: 5px;" |-
-! style="background: #F5F5F5; padding: 5px;" |[[Wheeze]]
-! style="background: #F5F5F5; padding: 5px;" |Normal
-! style="background: #F5F5F5; padding: 5px;" |↓[[Oxygen|O2]], ↑[[CO2]]
-! style="background: #F5F5F5; padding: 5px;" |Normal
-! style="background: #F5F5F5; padding: 5px;" |↓[[Tidal volume|Vt]], ↑[[Residual volume|RV]]
-! style="background: #F5F5F5; padding: 5px;" |[[Physical examination|Physical exam]]
-! style="background: #F5F5F5; padding: 5px;" |[[Allergic reaction]]
 |- style="background: #DCDCDC; padding: 5px; text-align: center;" |
 ![[Bronchiolitis]]<ref name="pmid23562737">{{cite journal |vauthors=Holbro A, Lehmann T, Girsberger S, Stern M, Gambazzi F, Lardinois D, Heim D, Passweg JR, Tichelli A, Bubendorf L, Savic S, Hostettler K, Grendelmeier P, Halter JP, Tamm M |title=Lung histology predicts outcome of bronchiolitis obliterans syndrome after hematopoietic stem cell transplantation |journal=Biol. Blood Marrow Transplant. |volume=19 |issue=6 |pages=973–80 |year=2013 |pmid=23562737 |doi=10.1016/j.bbmt.2013.03.017 |url=}}</ref>
@@ Line 465: / Line 141: @@
 ! style="background: #F5F5F5; padding: 5px;" |[[Clinical]] assessment
 ! style="background: #F5F5F5; padding: 5px;" |[[Respiratory syncytial virus|Respiratory syncytial virus (RSV)]]
-|- style="background: #DCDCDC; padding: 5px; text-align: center;" |
-![[COPD exacerbation resident survival guide|COPD exacerbation]]<ref name="pmid25177479">{{cite journal| author=Qureshi H, Sharafkhaneh A, Hanania NA| title=Chronic obstructive pulmonary disease exacerbations: latest evidence and clinical implications. | journal=Ther Adv Chronic Dis | year= 2014 | volume= 5 | issue= 5 | pages= 212-27 | pmid=25177479 | doi=10.1177/2040622314532862 | pmc=4131503 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=25177479  }}</ref>
-! style="background: #F5F5F5; padding: 5px;" |-
-! style="background: #F5F5F5; padding: 5px;" |+
-! style="background: #F5F5F5; padding: 5px;" |-
-! style="background: #F5F5F5; padding: 5px;" |+
-! style="background: #F5F5F5; padding: 5px;" |+
-! style="background: #F5F5F5; padding: 5px;" |+
-! style="background: #F5F5F5; padding: 5px;" |+
-! style="background: #F5F5F5; padding: 5px;" |-
-! style="background: #F5F5F5; padding: 5px;" |+
-! style="background: #F5F5F5; padding: 5px;" |+/-
-! style="background: #F5F5F5; padding: 5px;" |+/-
-! style="background: #F5F5F5; padding: 5px;" |+/-
-! style="background: #F5F5F5; padding: 5px;" |[[Wheeze]], [[Rhonchi]], and [[Crackles]]
-! style="background: #F5F5F5; padding: 5px;" |↑[[WBC]], ↑[[RBC]]
-! style="background: #F5F5F5; padding: 5px;" |[[Respiratory alkalosis]]
-! style="background: #F5F5F5; padding: 5px;" |Hyperexpansion
-! style="background: #F5F5F5; padding: 5px;" |↓ [[FEV1]]/[[FVC]]
-! style="background: #F5F5F5; padding: 5px;" |[[Clinical]] assessment
-! style="background: #F5F5F5; padding: 5px;" |[[Chronic bronchitis|Acute '''exacerbations''' of chronic bronchitis (AECB)]]
 |- style="background: #DCDCDC; padding: 5px; text-align: center;" |
 ![[Lung carcinoma]]<ref name="pmid22054876">{{cite journal| author=Dela Cruz CS, Tanoue LT, Matthay RA| title=Lung cancer: epidemiology, etiology, and prevention. | journal=Clin Chest Med | year= 2011 | volume= 32 | issue= 4 | pages= 605-44 | pmid=22054876 | doi=10.1016/j.ccm.2011.09.001 | pmc=3864624 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=22054876  }}</ref>
@@ Line 592: / Line 247: @@
 ! style="background: #F5F5F5; padding: 5px;" |[[Pneumothorax]]
 |- style="background: #DCDCDC; padding: 5px; text-align: center;" |
-! colspan="2" rowspan="5" |[[Cardiovascular system]]
+! colspan="2" rowspan="2" |[[Cardiovascular system]]
-![[Acute myocardial ischemia]]<ref name="pmid18307844">{{cite journal| author=Bruyninckx R, Aertgeerts B, Bruyninckx P, Buntinx F| title=Signs and symptoms in diagnosing acute myocardial infarction and acute coronary syndrome: a diagnostic meta-analysis. | journal=Br J Gen Pract | year= 2008 | volume= 58 | issue= 547 | pages= 105-11 | pmid=18307844 | doi=10.3399/bjgp08X277014 | pmc=2233977 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=18307844  }}</ref>
-! style="background: #F5F5F5; padding: 5px;" |+/-
-! style="background: #F5F5F5; padding: 5px;" |+
-! style="background: #F5F5F5; padding: 5px;" |-
-! style="background: #F5F5F5; padding: 5px;" |+/-
-! style="background: #F5F5F5; padding: 5px;" |+
-! style="background: #F5F5F5; padding: 5px;" |-
-! style="background: #F5F5F5; padding: 5px;" |+
-! style="background: #F5F5F5; padding: 5px;" |+
-! style="background: #F5F5F5; padding: 5px;" |-
-! style="background: #F5F5F5; padding: 5px;" |-
-! style="background: #F5F5F5; padding: 5px;" |-
-! style="background: #F5F5F5; padding: 5px;" |-
-! style="background: #F5F5F5; padding: 5px;" |Normal
-! style="background: #F5F5F5; padding: 5px;" |Normal
-! style="background: #F5F5F5; padding: 5px;" |Normal
-! style="background: #F5F5F5; padding: 5px;" |Normal
-! style="background: #F5F5F5; padding: 5px;" |Normal
-! style="background: #F5F5F5; padding: 5px;" |[[Cardiac troponin I (cTnI) and T (cTnT)|Cardiac troponin I]]
-! style="background: #F5F5F5; padding: 5px;" |[[Nausea and vomiting]], Positive pertinent risk factors, such as [[hypertension]], [[diabetes]], and [[smoking]]
-|- style="background: #DCDCDC; padding: 5px; text-align: center;" |
-![[Acute heart failure]]<ref name="GagginJanuzzi20132">{{cite journal|last1=Gaggin|first1=Hanna K.|last2=Januzzi|first2=James L.|title=Biomarkers and diagnostics in heart failure|journal=Biochimica et Biophysica Acta (BBA) - Molecular Basis of Disease|volume=1832|issue=12|year=2013|pages=2442–2450|issn=09254439|doi=10.1016/j.bbadis.2012.12.014}}</ref>
-! style="background: #F5F5F5; padding: 5px;" |+/-
-! style="background: #F5F5F5; padding: 5px;" |+
-! style="background: #F5F5F5; padding: 5px;" |-
-! style="background: #F5F5F5; padding: 5px;" |-
-! style="background: #F5F5F5; padding: 5px;" |+/-
-! style="background: #F5F5F5; padding: 5px;" |+
-! style="background: #F5F5F5; padding: 5px;" |+/-
-! style="background: #F5F5F5; padding: 5px;" |+
-! style="background: #F5F5F5; padding: 5px;" |+
-! style="background: #F5F5F5; padding: 5px;" |-
-! style="background: #F5F5F5; padding: 5px;" |+
-! style="background: #F5F5F5; padding: 5px;" |+
-! style="background: #F5F5F5; padding: 5px;" |[[S4|S]]3
-! style="background: #F5F5F5; padding: 5px;" |Normal
-! style="background: #F5F5F5; padding: 5px;" |[[Respiratory alkalosis]]
-! style="background: #F5F5F5; padding: 5px;" |↑ [[Cardiothoracic ratio]]
-! style="background: #F5F5F5; padding: 5px;" |↓[[Tidal volume|Vt]]
-! style="background: #F5F5F5; padding: 5px;" |[[B-type natriuretic peptide|B-type natriuretic peptide (BNP)]] and [[N-terminal pro b-type natriuretic peptide|N-terminal proBNP (NT-proBNP)]]
-! style="background: #F5F5F5; padding: 5px;" |[[Excessive sweating]], [[high blood pressure]]
-|- style="background: #DCDCDC; padding: 5px; text-align: center;" |
 ![[Pericardial tamponade]]<ref name="pmid12481882">{{cite journal |vauthors=van Steijn JH, Sleijfer DT, van der Graaf WT, van der Sluis A, Nieboer P |title=How to diagnose cardiac tamponade |journal=Neth J Med |volume=60 |issue=8 |pages=334–8 |year=2002 |pmid=12481882 |doi= |url=}}</ref>
 ! style="background: #F5F5F5; padding: 5px;" |+/-
@@ Line 655: / Line 268: @@
 ! style="background: #F5F5F5; padding: 5px;" |[[Echocardiography]]
 ! style="background: #F5F5F5; padding: 5px;" |Fluid accumulation in [[pericardium]]
-|- style="background: #DCDCDC; padding: 5px; text-align: center;" |
-![[Tachyarrhythmia]]<ref name="pmid18307844" />
-! style="background: #F5F5F5; padding: 5px;" |+/-
-! style="background: #F5F5F5; padding: 5px;" |+
-! style="background: #F5F5F5; padding: 5px;" |-
-! style="background: #F5F5F5; padding: 5px;" |-
-! style="background: #F5F5F5; padding: 5px;" |+/-
-! style="background: #F5F5F5; padding: 5px;" |-
-! style="background: #F5F5F5; padding: 5px;" |-
-! style="background: #F5F5F5; padding: 5px;" |-
-! style="background: #F5F5F5; padding: 5px;" |-
-! style="background: #F5F5F5; padding: 5px;" |-
-! style="background: #F5F5F5; padding: 5px;" |-
-! style="background: #F5F5F5; padding: 5px;" |-
-! style="background: #F5F5F5; padding: 5px;" |High [[pulse rate]]
-! style="background: #F5F5F5; padding: 5px;" |Normal
-! style="background: #F5F5F5; padding: 5px;" |Normal
-! style="background: #F5F5F5; padding: 5px;" |Normal
-! style="background: #F5F5F5; padding: 5px;" |Normal
-! style="background: #F5F5F5; padding: 5px;" |[[ECG]]
-! style="background: #F5F5F5; padding: 5px;" |[[Palpitation]]
 |- style="background: #DCDCDC; padding: 5px; text-align: center;" |
 ![[Pulmonary edema]]<ref name="MartindaleNoble2013">{{cite journal|last1=Martindale|first1=Jennifer L.|last2=Noble|first2=Vicki E.|last3=Liteplo|first3=Andrew|title=Diagnosing pulmonary edema|journal=European Journal of Emergency Medicine|volume=20|issue=5|year=2013|pages=356–360|issn=0969-9546|doi=10.1097/MEJ.0b013e32835c2b88}}</ref>
@@ Line 761: / Line 353: @@
 ! style="background: #F5F5F5; padding: 5px;" |[[Ct scan|Brain CT scan]]
 ! style="background: #F5F5F5; padding: 5px;" |[[Lucid interval]]
-|- style="background: #DCDCDC; padding: 5px; text-align: center;" |
-! colspan="2" rowspan="4" |[[Toxic]]/[[Metabolic]]
-![[Organophosphate poisoning]]<ref name="pmid25425841">{{cite journal| author=Peter JV, Sudarsan TI, Moran JL| title=Clinical features of organophosphate poisoning: A review of different classification systems and approaches. | journal=Indian J Crit Care Med | year= 2014 | volume= 18 | issue= 11 | pages= 735-45 | pmid=25425841 | doi=10.4103/0972-5229.144017 | pmc=4238091 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=25425841  }}</ref>
-! style="background: #F5F5F5; padding: 5px;" |+
-! style="background: #F5F5F5; padding: 5px;" |-
-! style="background: #F5F5F5; padding: 5px;" |-
-! style="background: #F5F5F5; padding: 5px;" |+
-! style="background: #F5F5F5; padding: 5px;" |-
-! style="background: #F5F5F5; padding: 5px;" |-
-! style="background: #F5F5F5; padding: 5px;" |-
-! style="background: #F5F5F5; padding: 5px;" |-
-! style="background: #F5F5F5; padding: 5px;" |-
-! style="background: #F5F5F5; padding: 5px;" |-
-! style="background: #F5F5F5; padding: 5px;" |-
-! style="background: #F5F5F5; padding: 5px;" |-
-! style="background: #F5F5F5; padding: 5px;" |[[Wheeze]]
-! style="background: #F5F5F5; padding: 5px;" |Normal
-! style="background: #F5F5F5; padding: 5px;" |↓[[Oxygen|O2]], ↑[[CO2]]
-! style="background: #F5F5F5; padding: 5px;" |Normal
-! style="background: #F5F5F5; padding: 5px;" |Normal
-! style="background: #F5F5F5; padding: 5px;" |[[Blood test]]
-! style="background: #F5F5F5; padding: 5px;" |[[Salivation]], [[Lacrimation]],  [[Emesis]], [[Miosis]]
-|- style="background: #DCDCDC; padding: 5px; text-align: center;" |
-![[Salicylate poisoning]]<ref name="pmid20440389">{{cite journal| author=Chin RL, Olson KR, Dempsey D| title=Salicylate toxicity from ingestion and continued dermal absorption. | journal=Cal J Emerg Med | year= 2007 | volume= 8 | issue= 1 | pages= 23-5 | pmid=20440389 | doi= | pmc=2859737 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=20440389  }}</ref>
-! style="background: #F5F5F5; padding: 5px;" |+
-! style="background: #F5F5F5; padding: 5px;" |-
-! style="background: #F5F5F5; padding: 5px;" |-
-! style="background: #F5F5F5; padding: 5px;" |-
-! style="background: #F5F5F5; padding: 5px;" |-
-! style="background: #F5F5F5; padding: 5px;" |-
-! style="background: #F5F5F5; padding: 5px;" |-
-! style="background: #F5F5F5; padding: 5px;" |-
-! style="background: #F5F5F5; padding: 5px;" |+
-! style="background: #F5F5F5; padding: 5px;" |-
-! style="background: #F5F5F5; padding: 5px;" |-
-! style="background: #F5F5F5; padding: 5px;" |-
-! style="background: #F5F5F5; padding: 5px;" |Normal
-! style="background: #F5F5F5; padding: 5px;" |Normal
-! style="background: #F5F5F5; padding: 5px;" |[[Metabolic acidosis]], [[Respiratory alkalosis]]
-! style="background: #F5F5F5; padding: 5px;" |Normal
-! style="background: #F5F5F5; padding: 5px;" |Normal
-! style="background: #F5F5F5; padding: 5px;" |[[Blood test]]
-! style="background: #F5F5F5; padding: 5px;" |[[Vomiting]], [[Tinnitus]], [[Confusion]], [[Hyperthermia]]
-|- style="background: #DCDCDC; padding: 5px; text-align: center;" |
-![[Carbon monoxide poisoning]]<ref name="pmid18710551">{{cite journal| author=Lane TR, Williamson WJ, Brostoff JM| title=Carbon monoxide poisoning in a patient with carbon dioxide retention: a therapeutic challenge. | journal=Cases J | year= 2008 | volume= 1 | issue= 1 | pages= 102 | pmid=18710551 | doi=10.1186/1757-1626-1-102 | pmc=2533003 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=18710551  }}</ref>
-! style="background: #F5F5F5; padding: 5px;" |+
-! style="background: #F5F5F5; padding: 5px;" |-
-! style="background: #F5F5F5; padding: 5px;" |-
-! style="background: #F5F5F5; padding: 5px;" |-
-! style="background: #F5F5F5; padding: 5px;" |+
-! style="background: #F5F5F5; padding: 5px;" |+
-! style="background: #F5F5F5; padding: 5px;" |-
-! style="background: #F5F5F5; padding: 5px;" |-
-! style="background: #F5F5F5; padding: 5px;" |+
-! style="background: #F5F5F5; padding: 5px;" |-
-! style="background: #F5F5F5; padding: 5px;" |-
-! style="background: #F5F5F5; padding: 5px;" |-
-! style="background: #F5F5F5; padding: 5px;" |[[Wheeze]]
-! style="background: #F5F5F5; padding: 5px;" |[[Carboxyhemoglobin]]
-! style="background: #F5F5F5; padding: 5px;" |↓[[Oxygen|O2]], ↑[[CO2]]
-! style="background: #F5F5F5; padding: 5px;" |Normal
-! style="background: #F5F5F5; padding: 5px;" |N/A
-! style="background: #F5F5F5; padding: 5px;" |[[Carboxyhemoglobin|Carboxyhemoglobin (HbCO)]] level
-! style="background: #F5F5F5; padding: 5px;" |[[Headache]], [[Dizziness]], [[Weakness]], [[Vomiting]], [[Confusion]]
-|- style="background: #DCDCDC; padding: 5px; text-align: center;" |
-![[Diabetic ketoacidosis]]<ref name="pmid23547550">{{cite journal |vauthors=Westerberg DP |title=Diabetic ketoacidosis: evaluation and treatment |journal=Am Fam Physician |volume=87 |issue=5 |pages=337–46 |date=March 2013 |pmid=23547550 |doi= |url= |author=}}</ref>
-! style="background: #F5F5F5; padding: 5px;" |+
-! style="background: #F5F5F5; padding: 5px;" |+/-
-! style="background: #F5F5F5; padding: 5px;" |-
-! style="background: #F5F5F5; padding: 5px;" |-
-! style="background: #F5F5F5; padding: 5px;" |-
-! style="background: #F5F5F5; padding: 5px;" |-
-! style="background: #F5F5F5; padding: 5px;" |-
-! style="background: #F5F5F5; padding: 5px;" |-
-! style="background: #F5F5F5; padding: 5px;" |-
-! style="background: #F5F5F5; padding: 5px;" |-
-! style="background: #F5F5F5; padding: 5px;" |-
-! style="background: #F5F5F5; padding: 5px;" |-
-! style="background: #F5F5F5; padding: 5px;" |Scattered [[wheeze]], [[Kussmaul breathing|Kussmaul's respiration]]
-! style="background: #F5F5F5; padding: 5px;" |↑[[WBC]]
-! style="background: #F5F5F5; padding: 5px;" |[[Metabolic acidosis]]
-! style="background: #F5F5F5; padding: 5px;" |Normal
-! style="background: #F5F5F5; padding: 5px;" |Normal
-! style="background: #F5F5F5; padding: 5px;" |[[Blood test]] ([[acidosis]], [[hyperglycemia]], [[ketonemia]])
-! style="background: #F5F5F5; padding: 5px;" |[[Vomiting]], [[Abdominal pain]], [[Weakness]], [[Confusion]]
-|- style="background: #DCDCDC; padding: 5px; text-align: center;" |
-! colspan="2" rowspan="3" |[[Systemic]]
-![[Panic attack]]<ref name="pmid16627512">{{cite journal| author=Taylor CB| title=Panic disorder. | journal=BMJ | year= 2006 | volume= 332 | issue= 7547 | pages= 951-5 | pmid=16627512 | doi=10.1136/bmj.332.7547.951 | pmc=1444835 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=16627512  }}</ref>
-! style="background: #F5F5F5; padding: 5px;" |+/-
-! style="background: #F5F5F5; padding: 5px;" |+
-! style="background: #F5F5F5; padding: 5px;" |-
-! style="background: #F5F5F5; padding: 5px;" |-
-! style="background: #F5F5F5; padding: 5px;" |-
-! style="background: #F5F5F5; padding: 5px;" |-
-! style="background: #F5F5F5; padding: 5px;" |-
-! style="background: #F5F5F5; padding: 5px;" |-
-! style="background: #F5F5F5; padding: 5px;" |-
-! style="background: #F5F5F5; padding: 5px;" |-
-! style="background: #F5F5F5; padding: 5px;" |-
-! style="background: #F5F5F5; padding: 5px;" |-
-! style="background: #F5F5F5; padding: 5px;" |Normal
-! style="background: #F5F5F5; padding: 5px;" |Normal
-! style="background: #F5F5F5; padding: 5px;" |Normal
-! style="background: #F5F5F5; padding: 5px;" |Normal
-! style="background: #F5F5F5; padding: 5px;" |Normal
-! style="background: #F5F5F5; padding: 5px;" |[[Clinical]] assessment
-! style="background: #F5F5F5; padding: 5px;" |[[Anxiety|Severe anxiety]]
-|- style="background: #DCDCDC; padding: 5px; text-align: center;" |
-![[Pregnancy]]<ref name="pmid28805596">{{cite journal |vauthors=Lee SY, Chien DK, Huang CH, Shih SC, Lee WC, Chang WH |title=Dyspnea in pregnancy |journal=Taiwan J Obstet Gynecol |volume=56 |issue=4 |pages=432–436 |date=August 2017 |pmid=28805596 |doi=10.1016/j.tjog.2017.04.035 |url= |author=}}</ref>
-! style="background: #F5F5F5; padding: 5px;" |-
-! style="background: #F5F5F5; padding: 5px;" |-
-! style="background: #F5F5F5; padding: 5px;" |-
-! style="background: #F5F5F5; padding: 5px;" |-
-! style="background: #F5F5F5; padding: 5px;" |+/-
-! style="background: #F5F5F5; padding: 5px;" |-
-! style="background: #F5F5F5; padding: 5px;" |-
-! style="background: #F5F5F5; padding: 5px;" |-
-! style="background: #F5F5F5; padding: 5px;" |-
-! style="background: #F5F5F5; padding: 5px;" |-
-! style="background: #F5F5F5; padding: 5px;" |-
-! style="background: #F5F5F5; padding: 5px;" |+
-! style="background: #F5F5F5; padding: 5px;" |Normal
-! style="background: #F5F5F5; padding: 5px;" |↑[[WBC]], [[RBC]]
-! style="background: #F5F5F5; padding: 5px;" |↓[[Oxygen|O2]], ↑[[CO2]]
-! style="background: #F5F5F5; padding: 5px;" |Normal
-! style="background: #F5F5F5; padding: 5px;" |↓[[Tidal volume|Vt]], ↑[[Residual volume|RV]]
-! style="background: #F5F5F5; padding: 5px;" |[[Human chorionic gonadotropin|βhCG]]
-! style="background: #F5F5F5; padding: 5px;" |Missed period, Hyperemesis
-|- style="background: #DCDCDC; padding: 5px; text-align: center;" |
-![[Sepsis]]<ref name="pmid27216810">{{cite journal| author=Askim Å, Mehl A, Paulsen J, DeWan AT, Vestrheim DF, Åsvold BO et al.| title=Epidemiology and outcome of sepsis in adult patients with Streptococcus pneumoniae infection in a Norwegian county 1993-2011: an observational study. | journal=BMC Infect Dis | year= 2016 | volume= 16 | issue=  | pages= 223 | pmid=27216810 | doi=10.1186/s12879-016-1553-8 | pmc=4877975 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=27216810  }}</ref>
-! style="background: #F5F5F5; padding: 5px;" |+/-
-! style="background: #F5F5F5; padding: 5px;" |-
-! style="background: #F5F5F5; padding: 5px;" |-
-! style="background: #F5F5F5; padding: 5px;" |+
-! style="background: #F5F5F5; padding: 5px;" |-
-! style="background: #F5F5F5; padding: 5px;" |-
-! style="background: #F5F5F5; padding: 5px;" |-
-! style="background: #F5F5F5; padding: 5px;" |-
-! style="background: #F5F5F5; padding: 5px;" |-
-! style="background: #F5F5F5; padding: 5px;" |-
-! style="background: #F5F5F5; padding: 5px;" |-
-! style="background: #F5F5F5; padding: 5px;" |-
-! style="background: #F5F5F5; padding: 5px;" |Normal
-! style="background: #F5F5F5; padding: 5px;" |↑[[WBC]], [[neutrophilia]]
-! style="background: #F5F5F5; padding: 5px;" |↓[[Oxygen|O2]], ↑[[CO2]]
-! style="background: #F5F5F5; padding: 5px;" |Normal
-! style="background: #F5F5F5; padding: 5px;" |Normal
-! style="background: #F5F5F5; padding: 5px;" |[[SIRS|SIRS criteria]]
-! style="background: #F5F5F5; padding: 5px;" |[[Chills]], [[Confusion]]
 |- style="background: #4479BA; color: #FFFFFF; text-align: center;"
 ! colspan="3" rowspan="3" |Organ system
@@ Line 939: / Line 382: @@
 !Gold standard
 |- style="background: #DCDCDC; padding: 5px; text-align: center;" |
-! rowspan="41" |Chronic Dyspnea
+! rowspan="18" |Chronic Dyspnea
-! rowspan="18" |[[Respiratory system]]
+! rowspan="9" |[[Respiratory system]]
-! rowspan="4" |[[Head]] and [[Neck]],
+! rowspan="2" |[[Head]] and [[Neck]],
 Upper [[airway]]
@@ Line 986: / Line 429: @@
 ! style="background: #F5F5F5; padding: 5px;" |[[Choking]] sensation
 |- style="background: #DCDCDC; padding: 5px; text-align: center;" |
-![[Vocal cord paralysis]]<ref name="pmid8828523" />
+! rowspan="7" |[[Chest]] and [[Pleura]],
-! style="background: #F5F5F5; padding: 5px;" |-
-! style="background: #F5F5F5; padding: 5px;" |-
-! style="background: #F5F5F5; padding: 5px;" |-
-! style="background: #F5F5F5; padding: 5px;" |-
-! style="background: #F5F5F5; padding: 5px;" |-
-! style="background: #F5F5F5; padding: 5px;" |+/-
-! style="background: #F5F5F5; padding: 5px;" |-
-! style="background: #F5F5F5; padding: 5px;" |-
-! style="background: #F5F5F5; padding: 5px;" |-
-! style="background: #F5F5F5; padding: 5px;" |-
-! style="background: #F5F5F5; padding: 5px;" |-
-! style="background: #F5F5F5; padding: 5px;" |-
-! style="background: #F5F5F5; padding: 5px;" |[[Stridor]]
-! style="background: #F5F5F5; padding: 5px;" |Normal
-! style="background: #F5F5F5; padding: 5px;" |Normal
-! style="background: #F5F5F5; padding: 5px;" |[[Pharyngeal constrictor|Pharyngeal constrictor muscles]] thinning, [[uvular]] deviation
-! style="background: #F5F5F5; padding: 5px;" |Normal
-! style="background: #F5F5F5; padding: 5px;" |[[Laryngoscopy]]
-! style="background: #F5F5F5; padding: 5px;" |[[Choking]] sensation
-|- style="background: #DCDCDC; padding: 5px; text-align: center;" |
-![[Tracheal stenosis]]<ref name="pmid23748638">{{cite journal |vauthors=Conti V, Calia N, Pasquini C, Zardi S, Finetti C, Stomeo F, Ravenna F |title=[Chronic cough and worsening dyspnea: a case of idiopathic tracheal stenosis] |language=Italian |journal=Recenti Prog Med |volume=104 |issue=4 |pages=156–8 |date=April 2013 |pmid=23748638 |doi=10.1701/1271.14026 |url= |author=}}</ref>
-! style="background: #F5F5F5; padding: 5px;" |-
-! style="background: #F5F5F5; padding: 5px;" |-
-! style="background: #F5F5F5; padding: 5px;" |-
-! style="background: #F5F5F5; padding: 5px;" |-
-! style="background: #F5F5F5; padding: 5px;" |+/-
-! style="background: #F5F5F5; padding: 5px;" |+/-
-! style="background: #F5F5F5; padding: 5px;" |-
-! style="background: #F5F5F5; padding: 5px;" |-
-! style="background: #F5F5F5; padding: 5px;" |+
-! style="background: #F5F5F5; padding: 5px;" |+
-! style="background: #F5F5F5; padding: 5px;" |-
-! style="background: #F5F5F5; padding: 5px;" |-
-! style="background: #F5F5F5; padding: 5px;" |[[Stridor]], [[Stertorous]]
-! style="background: #F5F5F5; padding: 5px;" |Normal
-! style="background: #F5F5F5; padding: 5px;" |↓[[Oxygen|O2]], ↑[[CO2]]
-! style="background: #F5F5F5; padding: 5px;" |[[Soft tissue]] thickening internal to normal-appearing [[Trachea|tracheal cartilage]]
-! style="background: #F5F5F5; padding: 5px;" |Normal
-! style="background: #F5F5F5; padding: 5px;" |[[Bronchoscopy]]
-! style="background: #F5F5F5; padding: 5px;" |[[Respiratory distress]]
-|- style="background: #DCDCDC; padding: 5px; text-align: center;" |
-! rowspan="14" |[[Chest]] and [[Pleura]],
 Lower [[airway]]
-![[Bronchial asthma]]<ref name="pmid19858243" />
+![[COPD]]<ref name="pmid25177479">{{cite journal| author=Qureshi H, Sharafkhaneh A, Hanania NA| title=Chronic obstructive pulmonary disease exacerbations: latest evidence and clinical implications. | journal=Ther Adv Chronic Dis | year= 2014 | volume= 5 | issue= 5 | pages= 212-27 | pmid=25177479 | doi=10.1177/2040622314532862 | pmc=4131503 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=25177479  }}</ref>
-! style="background: #F5F5F5; padding: 5px;" |-
-! style="background: #F5F5F5; padding: 5px;" |+
-! style="background: #F5F5F5; padding: 5px;" |+/-
-! style="background: #F5F5F5; padding: 5px;" |-
-! style="background: #F5F5F5; padding: 5px;" |+/-
-! style="background: #F5F5F5; padding: 5px;" |+
-! style="background: #F5F5F5; padding: 5px;" |-
-! style="background: #F5F5F5; padding: 5px;" |-
-! style="background: #F5F5F5; padding: 5px;" |+
-! style="background: #F5F5F5; padding: 5px;" |+
-! style="background: #F5F5F5; padding: 5px;" |-
-! style="background: #F5F5F5; padding: 5px;" |-
-! style="background: #F5F5F5; padding: 5px;" |[[Wheeze]]
-! style="background: #F5F5F5; padding: 5px;" |↑ [[Eosinophil]]
-! style="background: #F5F5F5; padding: 5px;" |[[Respiratory alkalosis]], [[Metabolic acidosis]]
-! style="background: #F5F5F5; padding: 5px;" |[[Pulmonary]] hyperinflation,
-[[Bronchial]] wall thickening
-! style="background: #F5F5F5; padding: 5px;" |↓ [[FEV1]]/[[FVC]]
-! style="background: #F5F5F5; padding: 5px;" |[[Spirometry]] before and after [[bronchodilator]]
-! style="background: #F5F5F5; padding: 5px;" |Paroxysmal [[respiratory distress]]
-|- style="background: #DCDCDC; padding: 5px; text-align: center;" |
-![[Bronchiectasis]]<ref name="CantinBankier2009" />
-! style="background: #F5F5F5; padding: 5px;" |-
-! style="background: #F5F5F5; padding: 5px;" |-
-! style="background: #F5F5F5; padding: 5px;" |-
-! style="background: #F5F5F5; padding: 5px;" |+
-! style="background: #F5F5F5; padding: 5px;" |+
-! style="background: #F5F5F5; padding: 5px;" |+
-! style="background: #F5F5F5; padding: 5px;" |-
-! style="background: #F5F5F5; padding: 5px;" |-
-! style="background: #F5F5F5; padding: 5px;" |+
-! style="background: #F5F5F5; padding: 5px;" |+
-! style="background: #F5F5F5; padding: 5px;" |-
-! style="background: #F5F5F5; padding: 5px;" |-
-! style="background: #F5F5F5; padding: 5px;" |[[Rhonchi]], [[Wheezing]], [[Crackles]]
-! style="background: #F5F5F5; padding: 5px;" |↑[[WBC]], [[neutrophilia]]
-! style="background: #F5F5F5; padding: 5px;" |↓[[Oxygen|O2]], ↑[[CO2]]
-! style="background: #F5F5F5; padding: 5px;" |[[Bronchiectasis chest x ray|Tram-track opacities]]
-! style="background: #F5F5F5; padding: 5px;" |↑ [[FEV1]]/[[FVC]]
-! style="background: #F5F5F5; padding: 5px;" |[[Computed tomography|High resolution computed tomography (HRCT)]]
-! style="background: #F5F5F5; padding: 5px;" |[[Productive cough|Chronic productive cough]]
-|- style="background: #DCDCDC; padding: 5px; text-align: center;" |
-![[COPD]]<ref name="pmid25177479" />
 ! style="background: #F5F5F5; padding: 5px;" |-
 ! style="background: #F5F5F5; padding: 5px;" |-
@@ Line 1,140: / Line 497: @@
 [[Ascites]], [[Pleural effusion]]
-|- style="background: #DCDCDC; padding: 5px; text-align: center;" |
-![[Interstitial lung disease]]<ref name="pmid2060395">{{cite journal |vauthors=Baughman RP, Shipley RT, Loudon RG, Lower EE |title=Crackles in interstitial lung disease. Comparison of sarcoidosis and fibrosing alveolitis |journal=Chest |volume=100 |issue=1 |pages=96–101 |year=1991 |pmid=2060395 |doi= |url=}}</ref>
-! style="background: #F5F5F5; padding: 5px;" |-
-! style="background: #F5F5F5; padding: 5px;" |-
-! style="background: #F5F5F5; padding: 5px;" |-
-! style="background: #F5F5F5; padding: 5px;" |-
-! style="background: #F5F5F5; padding: 5px;" |+
-! style="background: #F5F5F5; padding: 5px;" |+
-! style="background: #F5F5F5; padding: 5px;" |-
-! style="background: #F5F5F5; padding: 5px;" |-
-! style="background: #F5F5F5; padding: 5px;" |+
-! style="background: #F5F5F5; padding: 5px;" |+
-! style="background: #F5F5F5; padding: 5px;" |-
-! style="background: #F5F5F5; padding: 5px;" |-
-! style="background: #F5F5F5; padding: 5px;" |[[Rhonchi]], [[Wheezing]], [[Crackles]]
-! style="background: #F5F5F5; padding: 5px;" |Normal
-! style="background: #F5F5F5; padding: 5px;" |↓[[Oxygen|O2]], ↑[[CO2]]
-! style="background: #F5F5F5; padding: 5px;" |Peripheral [[pulmonary]] infiltrative opacification
-! style="background: #F5F5F5; padding: 5px;" |↑ [[FEV1]]/[[FVC]]
-! style="background: #F5F5F5; padding: 5px;" |[[Computed tomography|High resolution computed tomography (HRCT)]]
-! style="background: #F5F5F5; padding: 5px;" |[[Pneumoconiosis]]
 |- style="background: #DCDCDC; padding: 5px; text-align: center;" |
 ![[Sarcoidosis]]<ref name="pmid14518232">{{cite journal |vauthors=Moher D, Cole CW, Hill GB |title=Epidemiology of abdominal aortic aneurysm: the effect of differing definitions |journal=Eur J Vasc Surg |volume=6 |issue=6 |pages=647–50 |date=November 1992 |pmid=1451823 |doi= |url= |author=}}</ref>
@@ Line 1,182: / Line 518: @@
 ! style="background: #F5F5F5; padding: 5px;" |[[Computed tomography|High resolution computed tomography (HRCT)]]
 ! style="background: #F5F5F5; padding: 5px;" |[[Hypercalcemia]], high [[Angiotensin-converting enzyme|ACE]]
-|- style="background: #DCDCDC; padding: 5px; text-align: center;" |
-![[Alveolitis]]<ref name="pmid15692967">{{cite journal |vauthors=Khanna D, Clements PJ, Furst DE, Chon Y, Elashoff R, Roth MD, Sterz MG, Chung J, FitzGerald JD, Seibold JR, Varga J, Theodore A, Wigley FM, Silver RM, Steen VD, Mayes MD, Connolly MK, Fessler BJ, Rothfield NF, Mubarak K, Molitor J, Tashkin DP |title=Correlation of the degree of dyspnea with health-related quality of life, functional abilities, and diffusing capacity for carbon monoxide in patients with systemic sclerosis and active alveolitis: results from the Scleroderma Lung Study |journal=Arthritis Rheum. |volume=52 |issue=2 |pages=592–600 |date=February 2005 |pmid=15692967 |doi=10.1002/art.20787 |url= |author=}}</ref>
-! style="background: #F5F5F5; padding: 5px;" |-
-! style="background: #F5F5F5; padding: 5px;" |-
-! style="background: #F5F5F5; padding: 5px;" |-
-! style="background: #F5F5F5; padding: 5px;" |+
-! style="background: #F5F5F5; padding: 5px;" |+
-! style="background: #F5F5F5; padding: 5px;" |+
-! style="background: #F5F5F5; padding: 5px;" |-
-! style="background: #F5F5F5; padding: 5px;" |-
-! style="background: #F5F5F5; padding: 5px;" |-
-! style="background: #F5F5F5; padding: 5px;" |-
-! style="background: #F5F5F5; padding: 5px;" |-
-! style="background: #F5F5F5; padding: 5px;" |-
-! style="background: #F5F5F5; padding: 5px;" |Basal [[Crackles|crackle]]
-! style="background: #F5F5F5; padding: 5px;" |↑[[WBC]], [[neutrophilia]]
-! style="background: #F5F5F5; padding: 5px;" |Normal
-! style="background: #F5F5F5; padding: 5px;" | Basal reticulonodular opacification
-! style="background: #F5F5F5; padding: 5px;" |↑ [[FEV1]]/[[FVC]]
-! style="background: #F5F5F5; padding: 5px;" |[[Computed tomography|High resolution computed tomography (HRCT)]]
-! style="background: #F5F5F5; padding: 5px;" |[[Dry cough]]
-|- style="background: #DCDCDC; padding: 5px; text-align: center;" |
-![[Bronchiolitis obliterans]]<ref name="pmid23562737" />
-! style="background: #F5F5F5; padding: 5px;" |-
-! style="background: #F5F5F5; padding: 5px;" |-
-! style="background: #F5F5F5; padding: 5px;" |-
-! style="background: #F5F5F5; padding: 5px;" |+
-! style="background: #F5F5F5; padding: 5px;" |+
-! style="background: #F5F5F5; padding: 5px;" |+
-! style="background: #F5F5F5; padding: 5px;" |-
-! style="background: #F5F5F5; padding: 5px;" |-
-! style="background: #F5F5F5; padding: 5px;" |+
-! style="background: #F5F5F5; padding: 5px;" |+
-! style="background: #F5F5F5; padding: 5px;" |-
-! style="background: #F5F5F5; padding: 5px;" |-
-! style="background: #F5F5F5; padding: 5px;" |[[Wheeze|Expiratory wheeze]]
-! style="background: #F5F5F5; padding: 5px;" |↑[[WBC]]
-! style="background: #F5F5F5; padding: 5px;" |↓[[Oxygen|O2]], ↑[[CO2]]
-! style="background: #F5F5F5; padding: 5px;" |Hyperinflation,  Reticulonodular opacities
-! style="background: #F5F5F5; padding: 5px;" |↓ [[FEV1]]/[[FVC]]
-! style="background: #F5F5F5; padding: 5px;" |[[Biopsy|Lung biopsy]]
-! style="background: #F5F5F5; padding: 5px;" |Complication of [[Hematopoietic stem cell transplantation|allogeneic hematopoietic stem cell transplantation]]
-|- style="background: #DCDCDC; padding: 5px; text-align: center;" |
-![[Cystic fibrosis]]<ref name="ZieglerRovedder2009">{{cite journal|last1=Ziegler|first1=Bruna|last2=Rovedder|first2=Paula Maria Eidt|last3=Dalcin|first3=Paulo de Tarso Roth|last4=Menna-Barreto|first4=Sérgio Saldanha|title=Padrões ventilatórios na espirometria em pacientes adolescentes e adultos com fibrose cística|journal=Jornal Brasileiro de Pneumologia|volume=35|issue=9|year=2009|pages=854–859|issn=1806-3713|doi=10.1590/S1806-37132009000900006}}</ref>
-! style="background: #F5F5F5; padding: 5px;" |-
-! style="background: #F5F5F5; padding: 5px;" |-
-! style="background: #F5F5F5; padding: 5px;" |+
-! style="background: #F5F5F5; padding: 5px;" |+
-! style="background: #F5F5F5; padding: 5px;" |-
-! style="background: #F5F5F5; padding: 5px;" |+/-
-! style="background: #F5F5F5; padding: 5px;" |-
-! style="background: #F5F5F5; padding: 5px;" |-
-! style="background: #F5F5F5; padding: 5px;" |+
-! style="background: #F5F5F5; padding: 5px;" |+
-! style="background: #F5F5F5; padding: 5px;" |-
-! style="background: #F5F5F5; padding: 5px;" |-
-! style="background: #F5F5F5; padding: 5px;" |[[Rhonchi]], [[Wheezing]], [[Crackles]]
-! style="background: #F5F5F5; padding: 5px;" |Normal
-! style="background: #F5F5F5; padding: 5px;" |[[Metabolic alkalosis]]
-! style="background: #F5F5F5; padding: 5px;" |Thick-walled [[bronchiectasis]]
-! style="background: #F5F5F5; padding: 5px;" |↓ [[Forced expiratory volume|FEF<sub>75%</sub>]]/[[FVC]]
-! style="background: #F5F5F5; padding: 5px;" |[[Sweat test]]
-! style="background: #F5F5F5; padding: 5px;" |[[Congenital absence of the vas deferens|Absent vas deferens]]
 |- style="background: #DCDCDC; padding: 5px; text-align: center;" |
 ![[Pleural effusion]]<ref name="pmid25978627">{{cite journal |vauthors=Thomas R, Jenkins S, Eastwood PR, Lee YC, Singh B |title=Physiology of breathlessness associated with pleural effusions |journal=Curr Opin Pulm Med |volume=21 |issue=4 |pages=338–45 |date=July 2015 |pmid=25978627 |pmc=5633324 |doi=10.1097/MCP.0000000000000174 |url= |author=}}</ref>
@@ Line 1,266: / Line 539: @@
 ! style="background: #F5F5F5; padding: 5px;" |[[Pleural effusion causes|Light's criteria]]
 ! style="background: #F5F5F5; padding: 5px;" |↓[[Tactile fremitus]],  Asymmetrical [[chest expansion]]
-|- style="background: #DCDCDC; padding: 5px; text-align: center;" |
-![[Pulmonary shunt|Pulmonary right-to-left shunt]]<ref name="pmid19335916">{{cite journal| author=Vodoz JF, Cottin V, Glérant JC, Derumeaux G, Khouatra C, Blanchet AS et al.| title=Right-to-left shunt with hypoxemia in pulmonary hypertension. | journal=BMC Cardiovasc Disord | year= 2009 | volume= 9 | issue=  | pages= 15 | pmid=19335916 | doi=10.1186/1471-2261-9-15 | pmc=2671488 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=19335916  }}</ref>
-! style="background: #F5F5F5; padding: 5px;" |-
-! style="background: #F5F5F5; padding: 5px;" |-
-! style="background: #F5F5F5; padding: 5px;" |-
-! style="background: #F5F5F5; padding: 5px;" |-
-! style="background: #F5F5F5; padding: 5px;" |+/-
-! style="background: #F5F5F5; padding: 5px;" |+
-! style="background: #F5F5F5; padding: 5px;" |-
-! style="background: #F5F5F5; padding: 5px;" |-
-! style="background: #F5F5F5; padding: 5px;" |+
-! style="background: #F5F5F5; padding: 5px;" |+
-! style="background: #F5F5F5; padding: 5px;" |-
-! style="background: #F5F5F5; padding: 5px;" |-
-! style="background: #F5F5F5; padding: 5px;" |Diminished [[breath sounds]]
-! style="background: #F5F5F5; padding: 5px;" |Normal
-! style="background: #F5F5F5; padding: 5px;" |↓[[Oxygen|O2]], ↑[[CO2]], [[Respiratory acidosis]]
-! style="background: #F5F5F5; padding: 5px;" |Normal
-! style="background: #F5F5F5; padding: 5px;" |↓[[Tidal volume|Vt]], ↑[[Residual volume|RV]]
-([[physiological]])
-! style="background: #F5F5F5; padding: 5px;" |[[CT angiography|Pulmonary CT angiography]]
-! style="background: #F5F5F5; padding: 5px;" |Chronic [[hypoxemia]]
 |- style="background: #DCDCDC; padding: 5px; text-align: center;" |
 ![[Diaphragmatic paralysis]]<ref name="pmid27929389">{{cite journal| author=Dubé BP, Dres M| title=Diaphragm Dysfunction: Diagnostic Approaches and Management Strategies. | journal=J Clin Med | year= 2016 | volume= 5 | issue= 12 | pages=  | pmid=27929389 | doi=10.3390/jcm5120113 | pmc=5184786 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=27929389  }}</ref>
@@ Line 1,296: / Line 547: @@
 ! style="background: #F5F5F5; padding: 5px;" |+/-
 ! style="background: #F5F5F5; padding: 5px;" |+/-
-! style="background: #F5F5F5; padding: 5px;" |-
+! style="background: #F5F5F5; padding: 5px;" |+
-! style="background: #F5F5F5; padding: 5px;" |-
+! style="background: #F5F5F5; padding: 5px;" |+
 ! style="background: #F5F5F5; padding: 5px;" |-
 ! style="background: #F5F5F5; padding: 5px;" |-
@@ Line 1,334: / Line 585: @@
 ! style="background: #F5F5F5; padding: 5px;" |[[Night sweat]]
 |- style="background: #DCDCDC; padding: 5px; text-align: center;" |
-! colspan="2" rowspan="7" |[[Cardiovascular system]]
+! colspan="2" rowspan="2" |[[Cardiovascular system]]
 ![[Constrictive pericarditis]]<ref name="pmid12481882" />
 ! style="background: #F5F5F5; padding: 5px;" |-
@@ Line 1,355: / Line 606: @@
 ! style="background: #F5F5F5; padding: 5px;" |[[Computed tomography|Chest CT scan]]
 ! style="background: #F5F5F5; padding: 5px;" |[[Syncope]]
-|- style="background: #DCDCDC; padding: 5px; text-align: center;" |
-![[Restrictive cardiomyopathy]]<ref name="pmid118386552">{{cite journal |vauthors=Nakamura M, Satoh M, Kowada S, Satoh H, Tashiro A, Sato F, Masuda T, Hiramori K |title=Reversible restrictive cardiomyopathy due to light-chain deposition disease |journal=Mayo Clin. Proc. |volume=77 |issue=2 |pages=193–6 |date=February 2002 |pmid=11838655 |doi=10.4065/77.2.193 |url= |author=}}</ref>
-! style="background: #F5F5F5; padding: 5px;" |-
-! style="background: #F5F5F5; padding: 5px;" |-
-! style="background: #F5F5F5; padding: 5px;" |-
-! style="background: #F5F5F5; padding: 5px;" |-
-! style="background: #F5F5F5; padding: 5px;" |+
-! style="background: #F5F5F5; padding: 5px;" |-
-! style="background: #F5F5F5; padding: 5px;" |+
-! style="background: #F5F5F5; padding: 5px;" |+
-! style="background: #F5F5F5; padding: 5px;" |-
-! style="background: #F5F5F5; padding: 5px;" |-
-! style="background: #F5F5F5; padding: 5px;" |-
-! style="background: #F5F5F5; padding: 5px;" |+/-
-! style="background: #F5F5F5; padding: 5px;" |Normal
-! style="background: #F5F5F5; padding: 5px;" |Normal
-! style="background: #F5F5F5; padding: 5px;" |Normal
-! style="background: #F5F5F5; padding: 5px;" |Dilatation of the [[inferior vena cava]] and [[right atrium]]
-! style="background: #F5F5F5; padding: 5px;" |Normal
-! style="background: #F5F5F5; padding: 5px;" |[[Right ventricular]] [[biopsy]]
-! style="background: #F5F5F5; padding: 5px;" |[[Weight gain]],
-[[Nausea]]
-|- style="background: #DCDCDC; padding: 5px; text-align: center;" |
-![[Valvular heart disease]]<ref name="pmid18307844" />
-! style="background: #F5F5F5; padding: 5px;" |-
-! style="background: #F5F5F5; padding: 5px;" |-
-! style="background: #F5F5F5; padding: 5px;" |-
-! style="background: #F5F5F5; padding: 5px;" |-
-! style="background: #F5F5F5; padding: 5px;" |+
-! style="background: #F5F5F5; padding: 5px;" |-
-! style="background: #F5F5F5; padding: 5px;" |+/-
-! style="background: #F5F5F5; padding: 5px;" |+
-! style="background: #F5F5F5; padding: 5px;" |-
-! style="background: #F5F5F5; padding: 5px;" |-
-! style="background: #F5F5F5; padding: 5px;" |-
-! style="background: #F5F5F5; padding: 5px;" |-
-! style="background: #F5F5F5; padding: 5px;" |[[Cardiac murmur]]
-! style="background: #F5F5F5; padding: 5px;" |Normal
-! style="background: #F5F5F5; padding: 5px;" |Normal
-! style="background: #F5F5F5; padding: 5px;" |Dilatation of [[Heart chamber|heart chambers]]
-! style="background: #F5F5F5; padding: 5px;" |Normal
-! style="background: #F5F5F5; padding: 5px;" |[[Echocardiography]]
-! style="background: #F5F5F5; padding: 5px;" |[[Syncope]], [[Palpitation]]
-|- style="background: #DCDCDC; padding: 5px; text-align: center;" |
-![[Bradyarrhythmia]]<ref name="pmid28266824">{{cite journal |vauthors=Barstow C, McDivitt JD |title=Cardiovascular Disease Update: Bradyarrhythmias |journal=FP Essent |volume=454 |issue= |pages=18–23 |date=March 2017 |pmid=28266824 |doi= |url= |author=}}</ref>
-! style="background: #F5F5F5; padding: 5px;" |-
-! style="background: #F5F5F5; padding: 5px;" |-
-! style="background: #F5F5F5; padding: 5px;" |-
-! style="background: #F5F5F5; padding: 5px;" |-
-! style="background: #F5F5F5; padding: 5px;" |-
-! style="background: #F5F5F5; padding: 5px;" |-
-! style="background: #F5F5F5; padding: 5px;" |-
-! style="background: #F5F5F5; padding: 5px;" |-
-! style="background: #F5F5F5; padding: 5px;" |-
-! style="background: #F5F5F5; padding: 5px;" |-
-! style="background: #F5F5F5; padding: 5px;" |-
-! style="background: #F5F5F5; padding: 5px;" |-
-! style="background: #F5F5F5; padding: 5px;" |Normal
-! style="background: #F5F5F5; padding: 5px;" |Normal
-! style="background: #F5F5F5; padding: 5px;" |Normal
-! style="background: #F5F5F5; padding: 5px;" |Normal
-! style="background: #F5F5F5; padding: 5px;" |Normal
-! style="background: #F5F5F5; padding: 5px;" |[[ECG]]
-! style="background: #F5F5F5; padding: 5px;" |[[Syncope]], [[Palpitation]]
 |- style="background: #DCDCDC; padding: 5px; text-align: center;" |
 ![[Pericardial effusion]]<ref name="pmid23236323">{{cite journal| author=Jung HO| title=Pericardial effusion and pericardiocentesis: role of echocardiography. | journal=Korean Circ J | year= 2012 | volume= 42 | issue= 11 | pages= 725-34 | pmid=23236323 | doi=10.4070/kcj.2012.42.11.725 | pmc=3518705 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=23236323  }}</ref>
@@ Line 1,441: / Line 627: @@
 ! style="background: #F5F5F5; padding: 5px;" |[[M-mode echo: principles and classic findings|M-mode]] and [[Doppler echocardiography|2-dimensional Doppler echocardiography]]
 ! style="background: #F5F5F5; padding: 5px;" |[[Hoarseness]], [[Palpitation]]
-|- style="background: #DCDCDC; padding: 5px; text-align: center;" |
-![[Coronary heart disease]]<ref name="pmid18307844" />
-! style="background: #F5F5F5; padding: 5px;" |-
-! style="background: #F5F5F5; padding: 5px;" |+/-
-! style="background: #F5F5F5; padding: 5px;" |-
-! style="background: #F5F5F5; padding: 5px;" |-
-! style="background: #F5F5F5; padding: 5px;" |+
-! style="background: #F5F5F5; padding: 5px;" |-
-! style="background: #F5F5F5; padding: 5px;" |+
-! style="background: #F5F5F5; padding: 5px;" |+
-! style="background: #F5F5F5; padding: 5px;" |-
-! style="background: #F5F5F5; padding: 5px;" |-
-! style="background: #F5F5F5; padding: 5px;" |-
-! style="background: #F5F5F5; padding: 5px;" |-
-! style="background: #F5F5F5; padding: 5px;" |Normal
-! style="background: #F5F5F5; padding: 5px;" |Normal
-! style="background: #F5F5F5; padding: 5px;" |↓[[Oxygen|O2]]
-! style="background: #F5F5F5; padding: 5px;" |Normal
-! style="background: #F5F5F5; padding: 5px;" |Normal
-! style="background: #F5F5F5; padding: 5px;" |[[Cardiac troponin I (cTnI) and T (cTnT)|Cardiac troponin I]]
-! style="background: #F5F5F5; padding: 5px;" |[[Nausea]], [[Lightheadedness]], [[Sweating]]
-|- style="background: #DCDCDC; padding: 5px; text-align: center;" |
-![[Ventricular septal defect|Intracardiac shunt]]<ref name="pmid193359162">{{cite journal| author=Vodoz JF, Cottin V, Glérant JC, Derumeaux G, Khouatra C, Blanchet AS et al.| title=Right-to-left shunt with hypoxemia in pulmonary hypertension. | journal=BMC Cardiovasc Disord | year= 2009 | volume= 9 | issue=  | pages= 15 | pmid=19335916 | doi=10.1186/1471-2261-9-15 | pmc=2671488 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=19335916  }}</ref>
-! style="background: #F5F5F5; padding: 5px;" |-
-! style="background: #F5F5F5; padding: 5px;" |-
-! style="background: #F5F5F5; padding: 5px;" |-
-! style="background: #F5F5F5; padding: 5px;" |-
-! style="background: #F5F5F5; padding: 5px;" |+/-
-! style="background: #F5F5F5; padding: 5px;" |-
-! style="background: #F5F5F5; padding: 5px;" |+/-
-! style="background: #F5F5F5; padding: 5px;" |+
-! style="background: #F5F5F5; padding: 5px;" |+
-! style="background: #F5F5F5; padding: 5px;" |+
-! style="background: #F5F5F5; padding: 5px;" |-
-! style="background: #F5F5F5; padding: 5px;" |-
-! style="background: #F5F5F5; padding: 5px;" |[[Cardiac murmur|Cardiac continuous murmur]]
-! style="background: #F5F5F5; padding: 5px;" |Normal
-! style="background: #F5F5F5; padding: 5px;" |↓[[Oxygen|O2]]
-! style="background: #F5F5F5; padding: 5px;" |Dilatation of [[Heart chamber|heart chambers]]
-! style="background: #F5F5F5; padding: 5px;" |Normal
-! style="background: #F5F5F5; padding: 5px;" |[[Echocardiography]]
-! style="background: #F5F5F5; padding: 5px;" |[[Syncope]], [[Palpitation]]
 |- style="background: #DCDCDC; padding: 5px; text-align: center;" |
 ! colspan="2" rowspan="4" |[[Neuromuscular disease]]
@@ Line 1,571: / Line 715: @@
 [[Muscle weakness]]
 |- style="background: #DCDCDC; padding: 5px; text-align: center;" |
-! colspan="2" rowspan="2" |[[Toxic]]/[[Metabolic]]
+! colspan="2" rowspan="3" |[[Systemic]]
-![[Metabolic acidosis]]<ref name="pmid8350272">{{cite journal| author=Lane R, Adams L| title=Metabolic acidosis and breathlessness during exercise and hypercapnia in man. | journal=J Physiol | year= 1993 | volume= 461 | issue=  | pages= 47-61 | pmid=8350272 | doi= | pmc=1175244 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=8350272  }}</ref>
-! style="background: #F5F5F5; padding: 5px;" |-
-! style="background: #F5F5F5; padding: 5px;" |-
-! style="background: #F5F5F5; padding: 5px;" |+
-! style="background: #F5F5F5; padding: 5px;" |-
-! style="background: #F5F5F5; padding: 5px;" |-
-! style="background: #F5F5F5; padding: 5px;" |-
-! style="background: #F5F5F5; padding: 5px;" |-
-! style="background: #F5F5F5; padding: 5px;" |-
-! style="background: #F5F5F5; padding: 5px;" |-
-! style="background: #F5F5F5; padding: 5px;" |-
-! style="background: #F5F5F5; padding: 5px;" |-
-! style="background: #F5F5F5; padding: 5px;" |-
-! style="background: #F5F5F5; padding: 5px;" |Normal
-! style="background: #F5F5F5; padding: 5px;" |Normal
-! style="background: #F5F5F5; padding: 5px;" |[[Metabolic acidosis]], [[Respiratory alkalosis]]
-! style="background: #F5F5F5; padding: 5px;" |Normal
-! style="background: #F5F5F5; padding: 5px;" |Normal
-! style="background: #F5F5F5; padding: 5px;" |[[Arterial blood gas|ABG]]
-! style="background: #F5F5F5; padding: 5px;" |[[Confusion]], [[Vomiting]]
-|- style="background: #DCDCDC; padding: 5px; text-align: center;" |
-![[Renal failure]]<ref name="pmid12035070">{{cite journal |vauthors=DePalo LR |title=Fatal dyspnea in a patient with renal failure |journal=Mt. Sinai J. Med. |volume=69 |issue=3 |pages=113–20 |date=May 2002 |pmid=12035070 |doi= |url= |author=}}</ref>
-! style="background: #F5F5F5; padding: 5px;" |-
-! style="background: #F5F5F5; padding: 5px;" |-
-! style="background: #F5F5F5; padding: 5px;" |+
-! style="background: #F5F5F5; padding: 5px;" |-
-! style="background: #F5F5F5; padding: 5px;" |-
-! style="background: #F5F5F5; padding: 5px;" |-
-! style="background: #F5F5F5; padding: 5px;" |+
-! style="background: #F5F5F5; padding: 5px;" |+
-! style="background: #F5F5F5; padding: 5px;" |-
-! style="background: #F5F5F5; padding: 5px;" |-
-! style="background: #F5F5F5; padding: 5px;" |-
-! style="background: #F5F5F5; padding: 5px;" |+
-! style="background: #F5F5F5; padding: 5px;" |Normal
-! style="background: #F5F5F5; padding: 5px;" |↓ [[RBC]]
-! style="background: #F5F5F5; padding: 5px;" |[[Metabolic acidosis]]
-! style="background: #F5F5F5; padding: 5px;" |Normal
-! style="background: #F5F5F5; padding: 5px;" |Normal
-! style="background: #F5F5F5; padding: 5px;" |[[Creatinine|Cr]]
-! style="background: #F5F5F5; padding: 5px;" |[[Nausea]], [[Vomiting]], [[Oliguria]]
-|- style="background: #DCDCDC; padding: 5px; text-align: center;" |
-! colspan="2" rowspan="6" |[[Systemic]]
-![[Anemia]]<ref name="pmid23559772">{{cite journal| author=Sengupta A, Saha K, Jash D, Banerjee SN| title=Dyspnea with anemia turned out to be a case of hereditary hemorrhagic telangiectasia. | journal=Asian J Transfus Sci | year= 2013 | volume= 7 | issue= 1 | pages= 75-8 | pmid=23559772 | doi=10.4103/0973-6247.106745 | pmc=3613670 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=23559772  }}</ref>
-! style="background: #F5F5F5; padding: 5px;" |-
-! style="background: #F5F5F5; padding: 5px;" |-
-! style="background: #F5F5F5; padding: 5px;" |+
-! style="background: #F5F5F5; padding: 5px;" |-
-! style="background: #F5F5F5; padding: 5px;" |-
-! style="background: #F5F5F5; padding: 5px;" |-
-! style="background: #F5F5F5; padding: 5px;" |-
-! style="background: #F5F5F5; padding: 5px;" |+/-
-! style="background: #F5F5F5; padding: 5px;" |-
-! style="background: #F5F5F5; padding: 5px;" |-
-! style="background: #F5F5F5; padding: 5px;" |-
-! style="background: #F5F5F5; padding: 5px;" |-
-! style="background: #F5F5F5; padding: 5px;" |Normal
-! style="background: #F5F5F5; padding: 5px;" |↓ [[RBC]]
-! style="background: #F5F5F5; padding: 5px;" |↓[[Oxygen|O2]]
-! style="background: #F5F5F5; padding: 5px;" |Normal
-! style="background: #F5F5F5; padding: 5px;" |Normal
-! style="background: #F5F5F5; padding: 5px;" |[[Hemoglobin|HGB]], [[MCV]]
-! style="background: #F5F5F5; padding: 5px;" |[[Weakness]], [[Fatigue]]
-|- style="background: #DCDCDC; padding: 5px; text-align: center;" |
-![[Anxiety]]<ref name="pmid15200799">{{cite journal |vauthors=Bailey PH |title=The dyspnea-anxiety-dyspnea cycle--COPD patients' stories of breathlessness: "It's scary /when you can't breathe" |journal=Qual Health Res |volume=14 |issue=6 |pages=760–78 |date=July 2004 |pmid=15200799 |doi=10.1177/1049732304265973 |url= |author=}}</ref>
-! style="background: #F5F5F5; padding: 5px;" |+
-! style="background: #F5F5F5; padding: 5px;" |+
-! style="background: #F5F5F5; padding: 5px;" |+
-! style="background: #F5F5F5; padding: 5px;" |-
-! style="background: #F5F5F5; padding: 5px;" |+/-
-! style="background: #F5F5F5; padding: 5px;" |+/-
-! style="background: #F5F5F5; padding: 5px;" |-
-! style="background: #F5F5F5; padding: 5px;" |-
-! style="background: #F5F5F5; padding: 5px;" |-
-! style="background: #F5F5F5; padding: 5px;" |-
-! style="background: #F5F5F5; padding: 5px;" |-
-! style="background: #F5F5F5; padding: 5px;" |-
-! style="background: #F5F5F5; padding: 5px;" |Normal
-! style="background: #F5F5F5; padding: 5px;" |Normal
-! style="background: #F5F5F5; padding: 5px;" |Normal
-! style="background: #F5F5F5; padding: 5px;" |Normal
-! style="background: #F5F5F5; padding: 5px;" |Normal
-! style="background: #F5F5F5; padding: 5px;" |[[Psychological|Psychological interview]]
-! style="background: #F5F5F5; padding: 5px;" |[[Sweating]], [[Palpitation]]
-|- style="background: #DCDCDC; padding: 5px; text-align: center;" |
 ![[Ascites]]<ref name="pmid24336542">{{cite journal| author=Perri GA| title=Ascites in patients with cirrhosis. | journal=Can Fam Physician | year= 2013 | volume= 59 | issue= 12 | pages= 1297-9; e538-40 | pmid=24336542 | doi= | pmc=3860926 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=24336542  }}</ref>
 ! style="background: #F5F5F5; padding: 5px;" |-
@@ Line 1,677: / Line 736: @@
 ! style="background: #F5F5F5; padding: 5px;" |[[Medical ultrasonography|Abdominal ultrasound]]
 ! style="background: #F5F5F5; padding: 5px;" |[[Abdominal distention]]
-|- style="background: #DCDCDC; padding: 5px; text-align: center;" |
-![[Depression]]<ref name="pmid16516455">{{cite journal |vauthors=Neuman A, Gunnbjörnsdottir M, Tunsäter A, Nyström L, Franklin KA, Norrman E, Janson C |title=Dyspnea in relation to symptoms of anxiety and depression: A prospective population study |journal=Respir Med |volume=100 |issue=10 |pages=1843–9 |date=October 2006 |pmid=16516455 |doi=10.1016/j.rmed.2006.01.016 |url= |author=}}</ref>
-! style="background: #F5F5F5; padding: 5px;" |-
-! style="background: #F5F5F5; padding: 5px;" |+
-! style="background: #F5F5F5; padding: 5px;" |+
-! style="background: #F5F5F5; padding: 5px;" |-
-! style="background: #F5F5F5; padding: 5px;" |-
-! style="background: #F5F5F5; padding: 5px;" |-
-! style="background: #F5F5F5; padding: 5px;" |-
-! style="background: #F5F5F5; padding: 5px;" |-
-! style="background: #F5F5F5; padding: 5px;" |-
-! style="background: #F5F5F5; padding: 5px;" |-
-! style="background: #F5F5F5; padding: 5px;" |-
-! style="background: #F5F5F5; padding: 5px;" |-
-! style="background: #F5F5F5; padding: 5px;" |Normal
-! style="background: #F5F5F5; padding: 5px;" |Normal
-! style="background: #F5F5F5; padding: 5px;" |Normal
-! style="background: #F5F5F5; padding: 5px;" |Normal
-! style="background: #F5F5F5; padding: 5px;" |Normal
-! style="background: #F5F5F5; padding: 5px;" |[[Psychological|Psychological interview]]
-! style="background: #F5F5F5; padding: 5px;" |[[Depressed mood]], [[Fatigue]]
 |- style="background: #DCDCDC; padding: 5px; text-align: center;" |
 ![[Kyphoscoliosis]]<ref name="pmid26083538">{{cite journal| author=Qiabi M, Chagnon K, Beaupré A, Hercun J, Rakovich G| title=Scoliosis and bronchial obstruction. | journal=Can Respir J | year= 2015 | volume= 22 | issue= 4 | pages= 206-8 | pmid=26083538 | doi= | pmc=4530852 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=26083538  }}</ref>
@@ Line 1,744: / Line 782: @@
 [[Sweating]]
 |- style="background: #DCDCDC; padding: 5px; text-align: center;" |
-! colspan="2" rowspan="4" |[[Autoimmune]]
+|}</small></small>
-![[Churg-Strauss syndrome]]<ref name="pmid22554368">{{cite journal |vauthors=Uyar M, Elbek O, Bakır K, Kibar Y, Bayram N, Dikensoy Ö |title=Churg-Strauss syndrome related to montelukast |journal=Tuberk Toraks |volume=60 |issue=1 |pages=56–8 |date= 2012 |pmid=22554368 |doi= |url= |author=}}</ref>
-! style="background: #F5F5F5; padding: 5px;" |-
-! style="background: #F5F5F5; padding: 5px;" |-
-! style="background: #F5F5F5; padding: 5px;" |-
-! style="background: #F5F5F5; padding: 5px;" |-
-! style="background: #F5F5F5; padding: 5px;" |-
-! style="background: #F5F5F5; padding: 5px;" |+
-! style="background: #F5F5F5; padding: 5px;" |-
-! style="background: #F5F5F5; padding: 5px;" |-
-! style="background: #F5F5F5; padding: 5px;" |-
-! style="background: #F5F5F5; padding: 5px;" |-
-! style="background: #F5F5F5; padding: 5px;" |-
-! style="background: #F5F5F5; padding: 5px;" |-
-! style="background: #F5F5F5; padding: 5px;" |Scattered [[wheezing]]
-! style="background: #F5F5F5; padding: 5px;" |Normal
-! style="background: #F5F5F5; padding: 5px;" |Normal
-! style="background: #F5F5F5; padding: 5px;" |Areas of [[parenchymal]] opacification
-! style="background: #F5F5F5; padding: 5px;" |↓[[Tidal volume|Vt]], ↑[[Residual volume|RV]]
-! style="background: #F5F5F5; padding: 5px;" |[[Biopsy]]
-! style="background: #F5F5F5; padding: 5px;" |[[Fatigue]],[[Numbness]]
-|- style="background: #DCDCDC; padding: 5px; text-align: center;" |
-![[Microscopic polyangiitis]]<ref name="pmid26266064">{{cite journal| author=Tilanus A, Van der Niepen P, Geers C, Wissing KM| title=Pulmonary Limited MPO-ANCA Microscopic Polyangiitis and Idiopathic Lung Fibrosis in a Patient with a Diagnosis of IgA Nephropathy. | journal=Case Rep Nephrol | year= 2015 | volume= 2015 | issue=  | pages= 378170 | pmid=26266064 | doi=10.1155/2015/378170 | pmc=4525752 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=26266064  }}</ref>
-! style="background: #F5F5F5; padding: 5px;" |-
-! style="background: #F5F5F5; padding: 5px;" |-
-! style="background: #F5F5F5; padding: 5px;" |+/-
-! style="background: #F5F5F5; padding: 5px;" |+
-! style="background: #F5F5F5; padding: 5px;" |+
-! style="background: #F5F5F5; padding: 5px;" |-
-! style="background: #F5F5F5; padding: 5px;" |-
-! style="background: #F5F5F5; padding: 5px;" |-
-! style="background: #F5F5F5; padding: 5px;" |-
-! style="background: #F5F5F5; padding: 5px;" |-
-! style="background: #F5F5F5; padding: 5px;" |-
-! style="background: #F5F5F5; padding: 5px;" |+/-
-! style="background: #F5F5F5; padding: 5px;" |Scattered [[wheezing]]
-! style="background: #F5F5F5; padding: 5px;" |↑[[WBC]]
-! style="background: #F5F5F5; padding: 5px;" |↓[[Oxygen|O2]], ↑[[CO2]]
-! style="background: #F5F5F5; padding: 5px;" |Normal
-! style="background: #F5F5F5; padding: 5px;" |↓[[Tidal volume|Vt]], ↑[[Residual volume|RV]]
-! style="background: #F5F5F5; padding: 5px;" |[[Histological]] confirmation
-! style="background: #F5F5F5; padding: 5px;" |[[Skin lesions]], [[Nerve damage]]
-|- style="background: #DCDCDC; padding: 5px; text-align: center;" |
-![[Wegener's granulomatosis]]<ref name="pmid23034218">{{cite journal| author=Cardenas-Garcia J, Farmakiotis D, Baldovino BP, Kim P| title=Wegener's granulomatosis in a middle-aged woman presenting with dyspnea, rash, hemoptysis and recurrent eye complaints: a case report. | journal=J Med Case Rep | year= 2012 | volume= 6 | issue=  | pages= 335 | pmid=23034218 | doi=10.1186/1752-1947-6-335 | pmc=3492078 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=23034218  }}</ref>
-! style="background: #F5F5F5; padding: 5px;" |-
-! style="background: #F5F5F5; padding: 5px;" |-
-! style="background: #F5F5F5; padding: 5px;" |+/-
-! style="background: #F5F5F5; padding: 5px;" |-
-! style="background: #F5F5F5; padding: 5px;" |-
-! style="background: #F5F5F5; padding: 5px;" |+
-! style="background: #F5F5F5; padding: 5px;" |-
-! style="background: #F5F5F5; padding: 5px;" |-
-! style="background: #F5F5F5; padding: 5px;" |-
-! style="background: #F5F5F5; padding: 5px;" |-
-! style="background: #F5F5F5; padding: 5px;" |-
-! style="background: #F5F5F5; padding: 5px;" |-
-! style="background: #F5F5F5; padding: 5px;" |[[Wheezing]], [[Crackles]]
-! style="background: #F5F5F5; padding: 5px;" |↓ [[RBC]]
-! style="background: #F5F5F5; padding: 5px;" |↓[[Oxygen|O2]], ↑[[CO2]]
-! style="background: #F5F5F5; padding: 5px;" |Cavitate [[nodules]], ground-glass opacity
-! style="background: #F5F5F5; padding: 5px;" |↓ [[FEV1]]/[[FVC]]
-! style="background: #F5F5F5; padding: 5px;" |[[Biopsy]] demonstrating a [[granulomatous]] [[vasculitis]]
-! style="background: #F5F5F5; padding: 5px;" |[[Rhinosinusitis|Chronic rhinosinusitis]]
-|- style="background: #DCDCDC; padding: 5px; text-align: center;" |
-![[Goodpasture disease|Goodpasture's disease]]<ref name="BalDas2014">{{cite journal|last1=Bal|first1=Amanjit|last2=Das|first2=Ashim|last3=Gupta|first3=Dheeraj|last4=Garg|first4=Mandeep|title=Goodpasture’s Syndrome and p-ANCA Associated Vasculitis in a Patient of Silicosiderosis: An Unusual Association|journal=Case Reports in Pulmonology|volume=2014|year=2014|pages=1–7|issn=2090-6846|doi=10.1155/2014/398238}}</ref>
-! style="background: #F5F5F5; padding: 5px;" |-
-! style="background: #F5F5F5; padding: 5px;" |-
-! style="background: #F5F5F5; padding: 5px;" |-
-! style="background: #F5F5F5; padding: 5px;" |-
-! style="background: #F5F5F5; padding: 5px;" |-
-! style="background: #F5F5F5; padding: 5px;" |+
-! style="background: #F5F5F5; padding: 5px;" |-
-! style="background: #F5F5F5; padding: 5px;" |-
-! style="background: #F5F5F5; padding: 5px;" |-
-! style="background: #F5F5F5; padding: 5px;" |-
-! style="background: #F5F5F5; padding: 5px;" |-
-! style="background: #F5F5F5; padding: 5px;" |-
-! style="background: #F5F5F5; padding: 5px;" | Bilateral coarse [[crepitations]]
-! style="background: #F5F5F5; padding: 5px;" |↓ [[RBC]], [[Hemoglobin|HGB]], [[Hematocrit|HCT]]
-! style="background: #F5F5F5; padding: 5px;" |Normal
-! style="background: #F5F5F5; padding: 5px;" | Like [[Pulmonary edema chest x ray|pulmonary edema]]
-! style="background: #F5F5F5; padding: 5px;" |Normal
-! style="background: #F5F5F5; padding: 5px;" |[[Kidney]] [[biopsy]]
-! style="background: #F5F5F5; padding: 5px;" |[[Hematuria]],
-[[Hemoptysis]]
-|- style="background: #DCDCDC; padding: 5px; text-align: center;" |
-|}
-</small></small>
-==Related Chapters==
-* [[Air hunger]] - The sensation of an urgent need to breathe, sensation that you cannot take in a full breath
-* [[Tachypnea]] - Breathing rapidly
-* [[Bradypnea]] - Breathing slowly
-* [[Eupnea]] - Normal unlabored breathing
-* [[Orthopnea]] - Dyspnea that occurs with lying flat
-* [[Trepopnea]] - An abnormal awareness of one's own breathing that is seen in one lateral position but not in the other
-* [[Paroxysmal nocturnal dyspnea]] - Sudden, severe shortness of breath at night that awakens a person from sleep, often with coughing and wheezing.
 [[es:Disnea]]
 [[fr:Dyspnée]]
@@ Line 1,852: / Line 792: @@
 ==References==
-[[Category:Medicine]]
-[[Category:Emergency medicine]]
-[[Category:Pulmonology]]
-[[Category:Cardiology]]
-[[Category:primary care]]
-[[Category:Up-To-Date]]
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 {{WH}}
 {{WS}}
-[[Category: (name of the system)]]
+[[Category:Medicine]]
+[[Category:Emergency medicine]]
+[[Category:Pulmonology]]
+[[Category:Cardiology]]
+[[Category:Up-To-Date]]
+[[Category:(name of the system)]]

Diaphragmatic paralysis differential diagnosis: Difference between revisions

Latest revision as of 21:22, 29 July 2020

Overview

Differentiating diaphragmatic paralysis from other Diseases

References

References

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