II. Definition: Chronic Dyspnea

  1. Subjective difficult or distressed breathing >1 month

III. Causes

IV. History

V. Exam

  1. See Dyspnea

VI. Management: Empiric Therapy to consider

  1. Bronchodilator trial for episodic Dyspnea
  2. Proton Pump Inhibitor if GERD suspected

VII. Approach: Step 1 Evaluation for Dyspnea >1 month

  1. Complete Blood Count
  2. Chemistry panel (e.g. chem8)
  3. Chest XRay
  4. Electrocardiogram
  5. Pulse Oximetry (while walking)
  6. Spirometry or Peak Flow

VIII. Approach: Step 2 Evaluation (Indicated if negative Step 1)

IX. Approach: Step 3 Evaluation (Indicated if negative Step 2)

  1. Consider cardiology evaluation for angiography
  2. Consider pulmonology for bronchoscopy and biopsy
  3. Consider esophageal pH and manometry testing

Images: Related links to external sites (from Bing)

Related Studies (from Trip Database) Open in New Window