Pulmonary hypertension differential diagnosis: Difference between revisions

Jump to navigation Jump to search
No edit summary
 
(4 intermediate revisions by 4 users not shown)
Line 1: Line 1:
__NOTOC__
__NOTOC__
{{Pulmonary hypertension}}
[[Image:Home_logo1.png|right|250px|link=https://www.wikidoc.org/index.php/Pulmonary_hypertension]]
{{CMG}}; '''Assistant Editor(s)-in-Chief:''' [[User:Ralph Matar|Ralph Matar]], [[User:Rim Halaby|Rim Halaby]]
{{CMG}}; '''Assistant Editor(s)-in-Chief:''' [[User:Ralph Matar|Ralph Matar]], [[User:Rim Halaby|Rim Halaby]]


Line 22: Line 22:


==Differentiating Shortness of Breath or Dyspnea from other Diseases==
==Differentiating Shortness of Breath or Dyspnea from other Diseases==
* The underlying causes of dyspnea are classified as [[acute]] causes and [[chronic]] causes based on the disease course. Different causes of dyspnea include [[pulmonary]] ([[Upper airway|upper]] and [[Lower respiratory|lower airway]]), [[cardiovascular]], [[central nervous system]], [[toxic]] and [[metabolic]], and [[systemic]] diseases.
* The underlying causes of dyspnea are classified as [[acute]] causes and [[chronic]] causes based on the disease course. Different causes of dyspnea include [[pulmonary]] ([[Upper airway|upper]] and [[Lower respiratory|lower airway]]), [[cardiovascular]], [[central nervous system]], [[toxic]] and [[metabolic]], and [[systemic]] diseases.
'''Diseases that cause shortness of breath have to be differentiated upon the following table'''<ref name="pmid28098068">{{cite journal| author=Berliner D, Schneider N, Welte T, Bauersachs J| title=The Differential Diagnosis of Dyspnea. | journal=Dtsch Arztebl Int | year= 2016 | volume= 113 | issue= 49 | pages= 834-845 | pmid=28098068 | doi=10.3238/arztebl.2016.0834 | pmc=5247680 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=28098068  }} </ref>
'''Diseases that cause shortness of breath have to be differentiated upon the following table'''<ref name="pmid28098068">{{cite journal| author=Berliner D, Schneider N, Welte T, Bauersachs J| title=The Differential Diagnosis of Dyspnea. | journal=Dtsch Arztebl Int | year= 2016 | volume= 113 | issue= 49 | pages= 834-845 | pmid=28098068 | doi=10.3238/arztebl.2016.0834 | pmc=5247680 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=28098068  }} </ref>
Line 388: Line 389:
! style="background: #F5F5F5; padding: 5px;" |↓[[Tidal volume|Vt]], ↑[[Residual volume|RV]]
! style="background: #F5F5F5; padding: 5px;" |↓[[Tidal volume|Vt]], ↑[[Residual volume|RV]]
! style="background: #F5F5F5; padding: 5px;" |[[Bronchoscopy]] 
! style="background: #F5F5F5; padding: 5px;" |[[Bronchoscopy]] 
! style="background: #F5F5F5; padding: 5px;" |Paraneoplastic syndromes, such as [[Syndrome of inappropriate antidiuretic hormone|SIADH]] and [[Lambert-Eaton myasthenic syndrome|lambert-Eaton]]
! style="background: #F5F5F5; padding: 5px;" |Paraneoplastic syndromes, such as [[Syndrome of inappropriate antidiuretic hormone|SIADH]] and [[Lambert-Eaton myasthenic syndrome|Lambert-Eaton]]
|- style="background: #DCDCDC; padding: 5px; text-align: center;" |
|- style="background: #DCDCDC; padding: 5px; text-align: center;" |
![[Pneumonia]]<ref name="pmid25165554">{{cite journal| author=Simonetti AF, Viasus D, Garcia-Vidal C, Carratalà J| title=Management of community-acquired pneumonia in older adults. | journal=Ther Adv Infect Dis | year= 2014 | volume= 2 | issue= 1 | pages= 3-16 | pmid=25165554 | doi=10.1177/2049936113518041 | pmc=4072047 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=25165554  }}</ref>
![[Pneumonia]]<ref name="pmid25165554">{{cite journal| author=Simonetti AF, Viasus D, Garcia-Vidal C, Carratalà J| title=Management of community-acquired pneumonia in older adults. | journal=Ther Adv Infect Dis | year= 2014 | volume= 2 | issue= 1 | pages= 3-16 | pmid=25165554 | doi=10.1177/2049936113518041 | pmc=4072047 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=25165554  }}</ref>
Line 1,579: Line 1,580:
! 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;" |[[Psychological|Psychological interview]]
! style="background: #F5F5F5; padding: 5px;" |[[Depressed mood]], [[Fatigue]]
! style="background: #F5F5F5; padding: 5px;" |[[Depressed mood]], [[fatigue]]
|- style="background: #DCDCDC; padding: 5px; text-align: center;" |
|- 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>
![[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>

Latest revision as of 19:26, 23 August 2021

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Assistant Editor(s)-in-Chief: Ralph Matar, Rim Halaby

Overview

One of the most common initial presentations of patients with pulmonary hypertension is dyspnea; therefore, the differential diagnosis is very broad. As the disease progresses with time, more symptoms related to right ventricular hypertrophy and failure occur; which further narrows down the differential diagnosis.

Differential Diagnosis

Differentiating Pulmonary Arterial Hypertension from Other Diseases

Major entities in the differential diagnosis of pulmonary arterial hypertension are:[1]

Differentiating Shortness of Breath or Dyspnea from other Diseases

Diseases that cause shortness of breath have to be differentiated upon the following table[2]

To review the differential diagnosis of dyspnea and fever, click here.

To review the differential diagnosis of dyspnea and chest pain, click here.

To review the differential diagnosis of dyspnea and cough, click here.

To review the differential diagnosis of dyspnea and jugular vein distention, click here.

To review the differential diagnosis of dyspnea and cyanosis or clubbing, click here.

To review the differential diagnosis of dyspnea and loss of consciousness or agitation, click here.

To review the differential diagnosis of dyspnea with normal auscultation, click here.

To review the differential diagnosis of dyspnea with stridor, click here.

To review the differential diagnosis of dyspnea with wheezing, click here.

To review the differential diagnosis of dyspnea with crackle, click here.

To review the differential diagnosis of dyspnea with rhonchi, click here.

To review the differential diagnosis of dyspnea, fever, and cough, click here.

To review the differential diagnosis of dyspnea, fever, and chest pain, click here.

To review the differential diagnosis of dyspnea, cough, and cyanosis or clubbing click here.

To review the differential diagnosis of dyspnea, fever, chest pain, cough, and cyanosis or clubbing click here.

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
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

Angioedema[3] - - - - - +/- + - - +/- - + Normal Normal O2, ↑CO2 Normal N/A Physical exam Generalized edema
Anaphylaxis[4] +/- + - +/- - - - - +/- - - - Scattered wheezing Normal Normal Normal N/A Vital sign Type 1 hypersensitivity
Aspiration[5] - + - - +/- + - - + - - - Diminished breath sounds Normal Normal Atelectasis Vt, ↑RV Bronchoscopy Choking
Croup[6] - + - +/- - + - - + - - - Stridor WBC Normal Steeple sign Normal Physical exam Barking cough
Epiglottitis[7] - + - + - + - - - - - - Stridor WBC Normal Thumb sign Normal Laryngoscopy Drooling
Rhinosinusitis[8] - - - + - +/- - - - - - - Normal WBC Normal Air fluid level Normal Physical exam Headache
Vocal cord dysfunction[9] - - - - - +/- - - - - - - Stridor Normal Normal Normal FVC Laryngoscopy Choking sensation
Chest and Pleura,

Lower airway

Asthma attack[10] - + - - +/- + - - + - - - Wheeze Eosinophil Respiratory alkalosis Normal FEV1, PEF Physical exam and

Spirometry

Chest pain
Atelectasis - - - +/- +/- +/- - - +/- - - - Diminished breath sounds, Wheeze Normal O2, Normal/↓CO2 Collapsed lung lobe, fissuresdisplacement FVC Chest CT scan Surgical procedure, Aspiration,

Mechanical ventilation

Bronchitis[11] - - - + + + - - - - - - Rhonchi  WBC Normal Normal Normal Physical exam Rhonchi relieved by cough
Bronchospasm[12] +/- + - - + +/- - - + - - - Wheeze Normal O2, ↑CO2 Normal Vt, ↑RV Physical exam Allergic reaction
Bronchiolitis[13] - - - + +/- + - - - - - - Wheeze and Crackles WBC Normal Bronchovascular markings Vt Clinical assessment Respiratory syncytial virus (RSV)
COPD exacerbation[14] - + - + + + + - + +/- +/- +/- Wheeze, Rhonchi, and Crackles WBC, ↑RBC Respiratory alkalosis Hyperexpansion FEV1/FVC Clinical assessment Acute exacerbations of chronic bronchitis (AECB)
Lung carcinoma[15] - - + - - + - - + + - - Wheeze and Crackles Normal Normal Mass lesion, hilar lymphadenopathy Vt, ↑RV Bronchoscopy  Paraneoplastic syndromes, such as SIADH and Lambert-Eaton
Pneumonia[16] - - - + + + - - - - - - Wheeze, Rhonchi, and Crackles WBC, neutrophilia Normal Lobar consolidation Normal Chest X-ray and CT Scan productive cough
Pneumothorax[17] - - - - + - - - - - +/- - Diminished breath sounds Normal O2, ↑CO2 Radiolucency without lung marking Vt CXR and Chest CT scan Tracheal deviation
Pulmonary embolism[18] - - - - + - - +/- - - - - Normal Normal Respiratory alkalosis Normal Normal Pulmonary CT angiography Pleuritic chest pain
Rib fractures (flail chest)[19] - + - - + - - - - - - - Normal Normal Respiratory acidosis Fracture marks Normal Chest X-ray Pneumothorax
Cardiovascular system Acute myocardial ischemia[20] +/- + - +/- + - + + - - - - Normal Normal Normal Normal Normal Cardiac troponin I Nausea and vomiting, Positive pertinent risk factors, such as hypertension, diabetes, and smoking
Acute heart failure[21] +/- + - - +/- + +/- + + - + + S3 Normal Respiratory alkalosis Cardiothoracic ratio Vt B-type natriuretic peptide (BNP) and N-terminal proBNP (NT-proBNP) Excessive sweating, high blood pressure
Pericardial tamponade[22] +/- - - - + - +/- +/- - - + - Muffled heart sounds Normal Normal Water bottle appearance enlarged heart Normal Echocardiography Fluid accumulation in pericardium
Tachyarrhythmia[20] +/- + - - +/- - - - - - - - High pulse rate Normal Normal Normal Normal ECG Palpitation
Pulmonary edema[23] +/- + - + + + + + + + + + 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[24] + + - + - - - - - - - - Normal WBC, neutrophilia Normal Normal Normal CSF PCR Confusion
Traumatic brain injury[25] + +/- - - - - - - - - - - Normal Normal Respiratory acidosis Intracerebral hemorrhage Normal Brain CT scan Lucid interval
Toxic/Metabolic Organophosphate poisoning[26] + - - + - - - - - - - - Wheeze Normal O2, ↑CO2 Normal Normal Blood test Salivation, Lacrimation, Emesis, Miosis
Salicylate poisoning[27] + - - - - - - - + - - - Normal Normal Metabolic acidosis, Respiratory alkalosis Normal Normal Blood test Vomiting, Tinnitus, Confusion, Hyperthermia
Carbon monoxide poisoning[28] + - - - + + - - + - - - Wheeze Carboxyhemoglobin O2, ↑CO2 Normal N/A Carboxyhemoglobin (HbCO) level Headache, Dizziness, Weakness, Vomiting, Confusion
Diabetic ketoacidosis[29] + +/- - - - - - - - - - - Scattered wheeze, Kussmaul's respiration WBC Metabolic acidosis Normal Normal Blood test (acidosis, hyperglycemia, ketonemia) Vomiting, Abdominal pain, Weakness, Confusion
Systemic Panic attack[30] +/- + - - - - - - - - - - Normal Normal Normal Normal Normal Clinical assessment Severe anxiety
Pregnancy[31] - - - - +/- - - - - - - + Normal WBC, RBC O2, ↑CO2 Normal Vt, ↑RV βhCG Missed period, Hyperemesis
Sepsis[32] +/- - - + - - - - - - - - Normal WBC, neutrophilia O2, ↑CO2 Normal Normal SIRS criteria Chills, Confusion
Organ system Diseases Clinical manifestations Diagnosis Other features
Symptoms Physical exam
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[33] - - - - - - - - - - - + Normal Normal Normal Normal Normal Blood test (TSH, T4) Weight gain
Laryngeal adenocarcinoma[34] - - + - - +/- - - - - - - Stridor Normal O2, ↑CO2 Retropharyngeal tissue thickness Normal Laryngoscopy Choking sensation
Vocal cord paralysis[9] - - - - - +/- - - - - - - Stridor Normal Normal Pharyngeal constrictor muscles thinning, uvular deviation Normal Laryngoscopy Choking sensation
Tracheal stenosis[35] - - - - +/- +/- - - + + - - Stridor, Stertorous Normal O2, ↑CO2 Soft tissue thickening internal to normal-appearing tracheal cartilage Normal Bronchoscopy Respiratory distress
Chest and Pleura,

Lower airway

Bronchial asthma[10] - + +/- - +/- + - - + + - - Wheeze Eosinophil Respiratory alkalosis, Metabolic acidosis Pulmonary hyperinflation,

Bronchial wall thickening

FEV1/FVC Spirometry before and after bronchodilator Paroxysmal respiratory distress
Bronchiectasis[11] - - - + + + - - + + - - Rhonchi, Wheezing, Crackles WBC, neutrophilia O2, ↑CO2 Tram-track opacities FEV1/FVC High resolution computed tomography (HRCT) Chronic productive cough
COPD[14] - - +/- - - + + + + + + +/- Expiratory wheeze RBC Respiratory alkalosis, Metabolic acidosis ↑ Bronchovascular markings, Cardiomegaly FEV1/FVC Physical exam and

Spirometry

Heavy smoking history
Emphysema[36] - - - - - +/- - - + + - - Expiratory wheeze, Hyperinflation Normal Respiratory alkalosis, Metabolic acidosis Flattening of diaphragm, vertical heart FEV1/FVC Physical exam and

Spirometry

Barrel chest
Pulmonary hypertension[37] - - - - +/- +/- - - +/- +/- + + Accentuated S2 Normal Hypoxia and acidosis Enlarged pulmonary arteries Physiologic RV Cardiac catheterization Syncope,

Ascites, Pleural effusion

Interstitial lung disease[38] - - - - + + - - + + - - Rhonchi, Wheezing, Crackles Normal O2, ↑CO2 Peripheral pulmonary infiltrative opacification FEV1/FVC High resolution computed tomography (HRCT) Pneumoconiosis
Sarcoidosis[39] - - +/- - +/- + - - + - - - Crackles Normal O2, ↑CO2 Hilar adenopathy FEV1/FVC High resolution computed tomography (HRCT) Hypercalcemia, high ACE
Alveolitis[40] - - - + + + - - - - - - Basal crackle WBC, neutrophilia Normal  Basal reticulonodular opacification   FEV1/FVC High resolution computed tomography (HRCT) Dry cough
Bronchiolitis obliterans[13] - - - + + + - - + + - - Expiratory wheeze WBC O2, ↑CO2 Hyperinflation, Reticulonodular opacities FEV1/FVC Lung biopsy Complication of allogeneic hematopoietic stem cell transplantation
Cystic fibrosis[41] - - + + - +/- - - + + - - Rhonchi, Wheezing, Crackles Normal Metabolic alkalosis Thick-walled bronchiectasis FEF75%/FVC Sweat test Absent vas deferens
Pleural effusion[42] - +/- + - + - +/- - - - +/- +/- Egophony ("E-to-A" change) Normal Normal Blunting of the costophrenic and cardiophrenic angle Vt, ↑RV Light's criteria Tactile fremitus, Asymmetrical chest expansion
Pulmonary right-to-left shunt[43] - - - - +/- + - - + + - - Diminished breath sounds Normal O2, ↑CO2, Respiratory acidosis Normal Vt, ↑RV

(physiological)

Pulmonary CT angiography Chronic hypoxemia
Diaphragmatic paralysis[44] - - - +/- +/- +/- - - - - - - Normal Normal Normal Unilateral or bilateral diaphragmatic flattening Vt, ↑RV

(anatomical)

CXR confirmed by fluoroscopic sniff test Respiratory insufficiency
Tuberculosis[45] - - + + + + - - +/- - - - 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[22] - - - - + - + + - - + - Muffled heart sounds Normal Normal Calcifications  Normal Chest CT scan Syncope
Restrictive cardiomyopathy[46] - - - - + - + + - - - +/- Normal Normal Normal Dilatation of the inferior vena cava and right atrium Normal Right ventricular biopsy Weight gain,

Nausea

Valvular heart disease[20] - - - - + - +/- + - - - - Cardiac murmur Normal Normal Dilatation of heart chambers Normal Echocardiography Syncope, Palpitation
Bradyarrhythmia[47] - - - - - - - - - - - - Normal Normal Normal Normal Normal ECG Syncope, Palpitation
Pericardial effusion[48] - - - +/- + + +/- +/- - - + - Muffled heart sounds Normal Normal Fluid density around the heart Normal M-mode and 2-dimensional Doppler echocardiography Hoarseness, Palpitation
Coronary heart disease[20] - +/- - - + - + + - - - - Normal Normal O2 Normal Normal Cardiac troponin I Nausea, Lightheadedness, Sweating
Intracardiac shunt[49] - - - - +/- - +/- + + + - - Cardiac continuous murmur Normal O2 Dilatation of heart chambers Normal Echocardiography Syncope, Palpitation
Neuromuscular disease Amyotrophic lateral sclerosis[50] +/- - +/- - - - - - - - - - Normal WBC Normal Normal Vt, ↑RV Revised El Escorial criteria (clinical) Muscle weakness, Dysphagia
Polymyositis/dermatomyositis[51] - - +/- - + - - - - - - +/- Normal WBC Normal Normal Vt, ↑RV Muscle biopsy Muscle weakness, Heliotrope
Mitochondrial diseases[52] - - +/- - - - - - - - - - Wheeze WBC, Plt Normal Normal Vt, ↑RV Muscle biopsy Muscle pain
Glycolytic enzyme defects (e.g., McArdle)[53] +/- - - - - - - - - - - +/- Normal Normal Normal Normal Vt, ↑RV Muscle biopsy (ragged red fibers) Myoglobinuria,

Muscle weakness

Toxic/Metabolic Metabolic acidosis[54] - - + - - - - - - - - - Normal Normal Metabolic acidosis, Respiratory alkalosis Normal Normal ABG Confusion, Vomiting
Renal failure[55] - - + - - - + + - - - + Normal RBC Metabolic acidosis Normal Normal Cr Nausea, Vomiting, Oliguria
Systemic Anemia[56] - - + - - - - +/- - - - - Normal RBC O2 Normal Normal HGB, MCV Weakness, Fatigue
Anxiety[57] + + + - +/- +/- - - - - - - Normal Normal Normal Normal Normal Psychological interview Sweating, Palpitation
Ascites[58] - - - - - - - - - - - - Normal Normal Normal Peritoneal fluid accumulation Vt, ↑RV Abdominal ultrasound Abdominal distention
Depression[59] - + + - - - - - - - - - Normal Normal Normal Normal Normal Psychological interview Depressed mood, fatigue
Kyphoscoliosis[60] - - - - - - - - - - - - Wheeze Normal Normal Deviated vertebral column Vt, ↑RV

(anatomical)

Standing lateral spine radiograph Low back pain
Obesity[61] - - - - - - - - - - - - Normal Normal O2 Normal Vt, ↑RV

(anatomical)

BMI Low stamina,

Sweating

Autoimmune Churg-Strauss syndrome[62] - - - - - + - - - - - - Scattered wheezing Normal Normal Areas of parenchymal opacification Vt, ↑RV Biopsy  Fatigue,Numbness
Microscopic polyangiitis[63] - - +/- + + - - - - - - +/- Scattered wheezing WBC O2, ↑CO2 Normal Vt, ↑RV Histological confirmation Skin lesions, Nerve damage
Wegener's granulomatosis[64] - - +/- - - + - - - - - - Wheezing, Crackles RBC O2, ↑CO2 Cavitate nodules, ground-glass opacity FEV1/FVC Biopsy demonstrating a granulomatous vasculitis Chronic rhinosinusitis
Goodpasture's disease[65] - - - - - + - - - - - -  Bilateral coarse crepitations RBC, HGB, HCT Normal  Like pulmonary edema Normal Kidney biopsy Hematuria,

Hemoptysis

References

  1. Doi S (2008). "[Differential diagnosis of pulmonary hypertension]". Nihon Rinsho. 66 (11): 2127–32. PMID 19051731.
  2. Berliner D, Schneider N, Welte T, Bauersachs J (2016). "The Differential Diagnosis of Dyspnea". Dtsch Arztebl Int. 113 (49): 834–845. doi:10.3238/arztebl.2016.0834. PMC 5247680. PMID 28098068.
  3. Bernstein JA, Cremonesi P, Hoffmann TK, Hollingsworth J (2017). "Angioedema in the emergency department: a practical guide to differential diagnosis and management". Int J Emerg Med. 10 (1): 15. doi:10.1186/s12245-017-0141-z. PMC 5389952. PMID 28405953.
  4. Bjornsson HM, Graffeo CS (2010). "Improving diagnostic accuracy of anaphylaxis in the acute care setting". West J Emerg Med. 11 (5): 456–61. PMC 3027438. PMID 21293765.
  5. 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.
  6. Bjornson CL, Johnson DW (2013). "Croup in children". CMAJ. 185 (15): 1317–23. doi:10.1503/cmaj.121645. PMC 3796596. PMID 23939212.
  7. Negus VE (1927). "The Function of the Epiglottis". J Anat. 62 (Pt 1): 1–8. PMC 1250045. PMID 17104162.
  8. Meltzer EO, Hamilos DL (2011). "Rhinosinusitis diagnosis and management for the clinician: a synopsis of recent consensus guidelines". Mayo Clin Proc. 86 (5): 427–43. doi:10.4065/mcp.2010.0392. PMC 3084646. PMID 21490181.
  9. 9.0 9.1 Wood RP, Milgrom H (September 1996). "Vocal cord dysfunction". J. Allergy Clin. Immunol. 98 (3): 481–5. PMID 8828523.
  10. 10.0 10.1 Hodder R, Lougheed MD, Rowe BH, FitzGerald JM, Kaplan AG, McIvor RA (2010). "Management of acute asthma in adults in the emergency department: nonventilatory management". CMAJ. 182 (2): E55–67. doi:10.1503/cmaj.080072. PMC 2817338. PMID 19858243.
  11. 11.0 11.1 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.
  12. Molis MA, Molis WE (2010). "Exercise-induced bronchospasm". Sports Health. 2 (4): 311–7. doi:10.1177/1941738110373735. PMC 3445098. PMID 23015953.
  13. 13.0 13.1 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.
  14. 14.0 14.1 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.
  15. 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.
  16. 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.
  17. 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.
  18. 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.
  19. 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.
  20. 20.0 20.1 20.2 20.3 Bruyninckx R, Aertgeerts B, Bruyninckx P, Buntinx F (2008). "Signs and symptoms in diagnosing acute myocardial infarction and acute coronary syndrome: a diagnostic meta-analysis". Br J Gen Pract. 58 (547): 105–11. doi:10.3399/bjgp08X277014. PMC 2233977. PMID 18307844.
  21. Gaggin, Hanna K.; Januzzi, James L. (2013). "Biomarkers and diagnostics in heart failure". Biochimica et Biophysica Acta (BBA) - Molecular Basis of Disease. 1832 (12): 2442–2450. doi:10.1016/j.bbadis.2012.12.014. ISSN 0925-4439.
  22. 22.0 22.1 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.
  23. 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.
  24. 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.
  25. McAllister TW (2011). "Neurobiological consequences of traumatic brain injury". Dialogues Clin Neurosci. 13 (3): 287–300. PMC 3182015. PMID 22033563.
  26. Peter JV, Sudarsan TI, Moran JL (2014). "Clinical features of organophosphate poisoning: A review of different classification systems and approaches". Indian J Crit Care Med. 18 (11): 735–45. doi:10.4103/0972-5229.144017. PMC 4238091. PMID 25425841.
  27. Chin RL, Olson KR, Dempsey D (2007). "Salicylate toxicity from ingestion and continued dermal absorption". Cal J Emerg Med. 8 (1): 23–5. PMC 2859737. PMID 20440389.
  28. Lane TR, Williamson WJ, Brostoff JM (2008). "Carbon monoxide poisoning in a patient with carbon dioxide retention: a therapeutic challenge". Cases J. 1 (1): 102. doi:10.1186/1757-1626-1-102. PMC 2533003. PMID 18710551.
  29. Westerberg DP (March 2013). "Diabetic ketoacidosis: evaluation and treatment". Am Fam Physician. 87 (5): 337–46. PMID 23547550.
  30. Taylor CB (2006). "Panic disorder". BMJ. 332 (7547): 951–5. doi:10.1136/bmj.332.7547.951. PMC 1444835. PMID 16627512.
  31. Lee SY, Chien DK, Huang CH, Shih SC, Lee WC, Chang WH (August 2017). "Dyspnea in pregnancy". Taiwan J Obstet Gynecol. 56 (4): 432–436. doi:10.1016/j.tjog.2017.04.035. PMID 28805596.
  32. Askim Å, Mehl A, Paulsen J, DeWan AT, Vestrheim DF, Åsvold BO; et al. (2016). "Epidemiology and outcome of sepsis in adult patients with Streptococcus pneumoniae infection in a Norwegian county 1993-2011: an observational study". BMC Infect Dis. 16: 223. doi:10.1186/s12879-016-1553-8. PMC 4877975. PMID 27216810.
  33. 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.
  34. Schwenk NR, Schapira RM, Byrd JC (November 1994). "Laryngeal carcinoma presenting as platypnea". Chest. 106 (5): 1609–11. PMID 7956433.
  35. Conti V, Calia N, Pasquini C, Zardi S, Finetti C, Stomeo F, Ravenna F (April 2013). "[Chronic cough and worsening dyspnea: a case of idiopathic tracheal stenosis]". Recenti Prog Med (in Italian). 104 (4): 156–8. doi:10.1701/1271.14026. PMID 23748638.
  36. 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.
  37. 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.
  38. Baughman RP, Shipley RT, Loudon RG, Lower EE (1991). "Crackles in interstitial lung disease. Comparison of sarcoidosis and fibrosing alveolitis". Chest. 100 (1): 96–101. PMID 2060395.
  39. 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.
  40. 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 (February 2005). "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". Arthritis Rheum. 52 (2): 592–600. doi:10.1002/art.20787. PMID 15692967.
  41. Ziegler, Bruna; Rovedder, Paula Maria Eidt; Dalcin, Paulo de Tarso Roth; Menna-Barreto, Sérgio Saldanha (2009). "Padrões ventilatórios na espirometria em pacientes adolescentes e adultos com fibrose cística". Jornal Brasileiro de Pneumologia. 35 (9): 854–859. doi:10.1590/S1806-37132009000900006. ISSN 1806-3713.
  42. 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.
  43. Vodoz JF, Cottin V, Glérant JC, Derumeaux G, Khouatra C, Blanchet AS; et al. (2009). "Right-to-left shunt with hypoxemia in pulmonary hypertension". BMC Cardiovasc Disord. 9: 15. doi:10.1186/1471-2261-9-15. PMC 2671488. PMID 19335916.
  44. 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.
  45. 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.
  46. Nakamura M, Satoh M, Kowada S, Satoh H, Tashiro A, Sato F, Masuda T, Hiramori K (February 2002). "Reversible restrictive cardiomyopathy due to light-chain deposition disease". Mayo Clin. Proc. 77 (2): 193–6. doi:10.4065/77.2.193. PMID 11838655.
  47. Barstow C, McDivitt JD (March 2017). "Cardiovascular Disease Update: Bradyarrhythmias". FP Essent. 454: 18–23. PMID 28266824.
  48. 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.
  49. Vodoz JF, Cottin V, Glérant JC, Derumeaux G, Khouatra C, Blanchet AS; et al. (2009). "Right-to-left shunt with hypoxemia in pulmonary hypertension". BMC Cardiovasc Disord. 9: 15. doi:10.1186/1471-2261-9-15. PMC 2671488. PMID 19335916.
  50. 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.
  51. 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.
  52. 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.
  53. Tarui S (1995). "Glycolytic defects in muscle: aspects of collaboration between basic science and clinical medicine". Muscle Nerve Suppl. 3: S2–9. PMID 7603522.
  54. Lane R, Adams L (1993). "Metabolic acidosis and breathlessness during exercise and hypercapnia in man". J Physiol. 461: 47–61. PMC 1175244. PMID 8350272.
  55. DePalo LR (May 2002). "Fatal dyspnea in a patient with renal failure". Mt. Sinai J. Med. 69 (3): 113–20. PMID 12035070.
  56. Sengupta A, Saha K, Jash D, Banerjee SN (2013). "Dyspnea with anemia turned out to be a case of hereditary hemorrhagic telangiectasia". Asian J Transfus Sci. 7 (1): 75–8. doi:10.4103/0973-6247.106745. PMC 3613670. PMID 23559772.
  57. Bailey PH (July 2004). "The dyspnea-anxiety-dyspnea cycle--COPD patients' stories of breathlessness: "It's scary /when you can't breathe"". Qual Health Res. 14 (6): 760–78. doi:10.1177/1049732304265973. PMID 15200799.
  58. Perri GA (2013). "Ascites in patients with cirrhosis". Can Fam Physician. 59 (12): 1297–9, e538–40. PMC 3860926. PMID 24336542.
  59. Neuman A, Gunnbjörnsdottir M, Tunsäter A, Nyström L, Franklin KA, Norrman E, Janson C (October 2006). "Dyspnea in relation to symptoms of anxiety and depression: A prospective population study". Respir Med. 100 (10): 1843–9. doi:10.1016/j.rmed.2006.01.016. PMID 16516455.
  60. 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.
  61. 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.
  62. Uyar M, Elbek O, Bakır K, Kibar Y, Bayram N, Dikensoy Ö (2012). "Churg-Strauss syndrome related to montelukast". Tuberk Toraks. 60 (1): 56–8. PMID 22554368.
  63. Tilanus A, Van der Niepen P, Geers C, Wissing KM (2015). "Pulmonary Limited MPO-ANCA Microscopic Polyangiitis and Idiopathic Lung Fibrosis in a Patient with a Diagnosis of IgA Nephropathy". Case Rep Nephrol. 2015: 378170. doi:10.1155/2015/378170. PMC 4525752. PMID 26266064.
  64. Cardenas-Garcia J, Farmakiotis D, Baldovino BP, Kim P (2012). "Wegener's granulomatosis in a middle-aged woman presenting with dyspnea, rash, hemoptysis and recurrent eye complaints: a case report". J Med Case Rep. 6: 335. doi:10.1186/1752-1947-6-335. PMC 3492078. PMID 23034218.
  65. Bal, Amanjit; Das, Ashim; Gupta, Dheeraj; Garg, Mandeep (2014). "Goodpasture's Syndrome and p-ANCA Associated Vasculitis in a Patient of Silicosiderosis: An Unusual Association". Case Reports in Pulmonology. 2014: 1–7. doi:10.1155/2014/398238. ISSN 2090-6846.