Dyspnea differential diagnosis

Dyspnea Microchapters
Patient Information
Overview
Pathophysiology
Causes
Differentiating Dyspnea from other Diseases

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Differential Diagnosis

• 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.

 Shortness of breath/Dyspnea

Organ system			Diseases	Clinical manifestations												Diagnosis						Other features
				Symptoms						Physical exam
				Loss of consciousness	Agitation	Weight loss	Fever	Chest pain	Cough	Cyanosis	Clubbing	JVD	Peripheral edema	Tenderness	Auscultation	CBC	ESR	ABG	Imaging	PFT	Gold standard
Acute Dyspnea	Respiratory system	Head and Neck, Upper airway	Angioedema	-	-	-	-	-	+/-	-	+/-	-	++	-	Normal	-	-	↓O2, ↑CO2	Normal
			Anaphylaxis	-
			Aspiration
			Croup
			Epiglottitis
			Rhinosinusitis
			Vocal cord dysfunction
		Chest and Pleura, Lower airway	Asthma attack
			Bronchitis
			Bronchospasm
			Bronchiolitis
			COPD exacerbation
			Lung carcinoma
			Pneumonia
			Pneumothorax
			Pulmonary embolism
			Rib fractures (flail chest)
	Cardiovascular system		Acute myocardial ischemia
			Acute heart failure
			Pericardial tamponade
			Tachyarrhythmia
			Pulmonary edema
	Central nervous system		Stroke
			Encephalitis
			Traumatic brain injury
	Toxic/Metabolic		Organophosphate poisoning
			Salicylate poisoning
			Carbon monoxide poisoning
			Diabetic ketoacidosis
	Systemic		Panic attack
			Pregnancy
			Sepsis
Organ system			Diseases	Clinical manifestations												Diagnosis						Other features
				Symptoms						Physical exam
				Loss of consciousness	Agitation	Weight loss	Fever	Chest pain	Cough	Cyanosis	Clubbing	JVD	Peripheral edema	Tenderness	Auscultation	CBC	ESR	ABG	Imaging	PFT	Gold standard
Chronic Dyspnea	Respiratory system	Head and Neck, Upper airway	Goiter
			Laryngeal adenocarcinoma
			Vocal cord paralysis
			Tracheal stenosis
		Chest and Pleura, Lower airway	Bronchial asthma
			Bronchiectasis
			COPD
			Emphysema
			Pulmonary hypertension
			Interstitial lung disease
			Sarcoidosis
			Alveolitis
			Bronchiolitis obliterans
			Cystic fibrosis
			Pleural effusion
			Pulmonary right-to-left shunt
			Phrenic nerve palsy
			Tuberculosis
	Cardiovascular system		Constrictive pericarditis
			Restrictive cardiomyopathy
			Valvular heart disease
			Bradyarrhythmia
			Pericardial effusion
			Coronary heart disease
			Intracardiac shunt
	Neuromuscular disease		Amyotrophic lateral sclerosis
			Polymyositis/dermatomyositis
			Mitochondrial diseases
			Glycolytic enzyme defects (e.g., McArdle)
	Toxic/Metabolic		Metabolic acidosis
			Renal failure
	Systemic		Anemia
			Anxiety
			Ascites
			Depression
			Kyphoscoliosis
			Obesity
	Autoimmune		Churg-Strauss syndrome
			Microscopic polyangiitis
			Wegener's granulomatosis
			Goodpasture's disease