DYSPNOEA

Key points

Causes for severe dyspnea are:

COAD Acute pulmonary oedema
Onset/course Respiratory prodromal symptoms Explosive
General appearance Barrel chest Old CABG scar
Sweating No Yes
Fever Yes No (unless precipitating infection)
Raised JVP No (if no cor pulmonale) Yes
Hypertension   Common (but not in cardiogenic shock)
Heart sounds Faint Gallop rhythm
Chest Expiratory +/- inspiratory wheeze (+/ creps) Inspiratory creps or wheeze

Other serious causes of dyspnea

OBTAIN A CXR

COAD Acute pulmonary oedema
Hyperinflated
Decreased lung markings
+/- focal consolidation
Cardiomegaly
Kerley B lines
Upper lobe diversion
Hilar opacities