Dyspnea Research ...

Mike did some research re Dyspnea ...
From my surfings on the web regarding shortness of breath(non-academic sites)

Over 950 reasons exist for causes of shortness of breath.

Some of the more common causes include:
▫ anaphylaxis
▫ anxiety
▫ asthma
▫ bronchitis
▫ carbon monoxide poisoning
▫ chronic obstructive pulmonary disease
▫ cystic fibrosis
▫ collapsed lung (pneumothorax)
▫ congestive heart failure
▫ COPD
▫ emphysema
▫ exercise
▫ high fever
▫ hyperventilation syndrome
▫ pneumonia
▫ pulmonary embolism

Questions we might want to ask:
▫ sudden onset, severe, chest pain/tightness (MI, pneumothorax, pulmonary embolism, atelectasis)
▫ episodic with wheezing or coughing (asthma, infection)
▫ gradually getting worse over time (in periods of weeks or months, not days or hours) exposure to noxious fumes, smoking (COPD, chronic bronchitis)
▫ worked in or around asbestos, wood dust, industrial fumes or in a coal mine (occupational lung disease)
▫ with swollen feet or ankles, and harder to breath when lying flat (congestive heart failure)
▫ with tiredness, dry cough, chest pain and worse with exertion (interstitial lung disease, sarcoidosis, pulmonary hypertension)
▫ With pale skin and tired all the time (anemia)
▫ with rapid breathing, dizziness, numbness or tingling in hands or mouth (hyperventilation)
▫ with fever
o With painful cough or blood and mucous (infection, cancer)
o Cold symptoms and a mucous-producing cough (bronchitis, pneumonia)
o With dry cough and chest pain (histoplasmosis (fungal infection)
o With chest pain, chills, coughing up pus (lung abcess)

Questions put another way:
▫ How long have you had SOB? – acute or chronic
▫ Sudden onset?
o if sudden - respiratory distress syndrome, pulmonary embolism, pneumothorax, lung collapse
o If gradual onset - chronic diseases such as congestive cardiac failure, emphysema and fibrosis.
▫ What makes it worse? – exertion, lying flat
▫ Recent history of bleeding - anemia
▫ Past medical history? - previous respiratory illness (pneumonia, tuberculosis, chronic bronchitis); previous heart problems (heart disease, heart attack, heart valve disease); HIV infection ( at high risk for Pneumocystis carinii pneumonia); previous high blood pressure; deep venous thrombosis; rheumatic fever.
▫ Medications
▫ Cigarette smoking
▫ Drug history - cocaine, amphetamines, injected narcotics
▫ Alcohol? - aspiration pneumonia, klebsiella pneumonia
▫ Occupational history?
▫ Allergies?
▫ Family history? - asthma, cystic fibrosis, emphysema, alpha-1-anti-typsin deficiency, tuberculosis, heart attacks.

Related symptoms questions:
▫ With cough? – lung disease, heart disease
▫ Color and quantity of sputum, if any? - large volume pus-like - bronchiectasis or pneumonia; foul smelling dark colored - lung abscess; pink frothy secretions - left ventricular heart failure; blood - lung disease
▫ With audible wheeze? - asthma, chronic bronchitis, emphysema, airways obstruction (by a foreign body or tumor), left ventricular heart failure
▫ With chest pain? - lung disease, heart disease
▫ With fever? - at night - tuberculosis, pneumonia, mesothelioma
▫ Orthopnea? - suggests left ventricular heart failure.
▫ With stridor? - obstruction of larynx, trachea or large airways by a foreign body, tumor or infection
▫ With ankle swelling? - heart failure.
▫ With heart palpations? - heart arrhythmia
▫ Fever and pus-like sputum? - pneumonia
▫ Chest pain with blood in sputum? - pulmonary embolism