<< Dyspnea: Fear, Loathing, and Physiology

Key Points In Dealing With Dyspnea

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Key Points In Dealing With Dyspnea

Key Points In Dealing With Dyspnea

  1. All patients with new-onset hypoxemia need a diagnosis, admission, or both.
  2. The alveolar-arterial oxygen gradient is only reliable in a patient breathing room air.
  3. A normal alveolar-arterial oxygen gradient does not rule out PE.
  4. The combination of any two of the following?a normal SimpliRED D-dimer, a PO2 ? 80 mmHg, or a respiratory rate less than 20?is unlikely to be associated with pulmonary embolism.
  5. Painless dyspnea may occur in as many as one-third of patients with coronary artery disease.
  6. A normal peak flow essentially rules out reactive airway disease as a cause for dyspnea.
  7. The peak expiratory flow rate (PEFR) can help differentiate CHF from obstructive airway disease as a cause of dyspnea.
  8. Patients with acute bronchitis and normal peak flow rarely complain of dyspnea.
  9. While dyspnea is common in normal pregnancy, exclude pulmonary embolism and eclampsia.
  10. Psychogenic dyspnea or deconditioning dyspnea are diagnoses of exclusion.
  11. One-third of ED patients with PE have painless dyspnea.
  12. Diaphoresis often signifies a serious etiology?no one fakes diaphoresis.
  13. Pulse oximetry may be normal in patients with pulmonary embolism.
  14. A normal ECG has a 98% negative predictive value for left ventricular systolic dysfunction.
Publication Information

Jeffrey A. Kline

Publication Date

August 1, 1999

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