Friday, 29th September 2017
29 September 2017
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Dyspnoea – Treatment

Dyspnoea – Treatment

Dyspnea is a subjective experience or perception of uncomfortable breathing. However, the relationship between the level of dyspnea and the severity of the underlying disease varies widely across individuals. Dyspnea can result from conditions that increase the mechanical effort of breathing conditions that produce compensatory tachypnea or psychogenic conditions. The following factors play a role in how and when dyspnea presents in patients: the rate of onset, previous dyspnea, medication comorbidities, psychological profile and severity of the underlying disorder.

Clinical Findings

Symptoms

The duration, severity, and periodicity of dyspnea influence the tempo of the clinical evaluation. Rapid onset or severe dyspnea in the absence of other clinical features should raise concern for pneumothorax, pulmonary embolism or increased left ventricular end- diastolic pressure.

Physical Examination

A focused physical examination should include evaluation of the head and neck, chest, heart, and lower extremities. Visual inspection of the patient can suggest obstructive airway disease, pneumothorax or metabolic acidosis.

Diagnosis Studies

Causes of dyspnea that can be managed without chest radiography are few: Ingestions causing lactic acidosis anemia, methemoglobinemia, and carbon monoxide poisoning.

Causes 

An episode of dyspnea is not always directly related to an individual’s health. A person can feel short of breath after intense exercise, when traveling to a high altitude, or going through major temperature changes.

However, dyspnea usually relates to health problems. Sometimes, it is just a case of being out of shape, and exercise can improve symptoms. But dyspnea can be a sign of a serious health issue.

Treatment 

Management of mild hemoptysis consists of identifying and treating the specific cause. Massive hemoptysis is life threatening.

When to Refer 

The patient should be referred to a  pulmonologist when bronchoscopic evaluation of the lower respiratory tract is required.

Patients should be referred to an otolaryngologist when an upper respiratory tract bleeding source is identified.

Patient with severe coagulopathy complicating management should be referred to a hematologist.

When to Admit

To stabilize bleeding process in patients at risk experiencing massive hemoptysis.

To correct disordered coagulation.

To stabilize gas exchange.

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