Breathlessness Flashcards
A 73 year old male complains of chest tightness on exertion, breathlessness that has gotten progressively worse in the past year as well as pre-syncope. He has no significant previous medical history and says he has lived an active life. His blood pressure is 100/80 and a BMI is 21.0. What condition does this patient have?
Angina
A 42 year old female comes to the GP complaining of chest tightness when she is running. She feels breathless and reports that she fainted twice when the pain came on. She is a marathon runner, says she doesn’t smoke or drink alcohol, and hasn’t ever been ill other than one time she got the flu. On examination you hear an ejection systolic murmur on the right sternal border. What do you think is the underlying reason for her presentation?
Aortic Stenosis due to bicuspid aortic valve
A 45 year old male comes to the GP complaining of shortness of breath. He says that he cannot be as active as he used to be and is experiencing palpatations at random intervals. You order and ECG and find an irregularly irregular rhythm and on examination hear a diastolic murmur in the 5th intercostal space of the left mid-clavicular line. What does this patient have?
Mitral Stenosis
A 69 year old male comes to the GP because of breathlessness. He says that it has gotten worse in the past few months and also mentions that he can’t fit into his shoes anymore. He has a previous history of a STEMI 6 months ago, has a BMI of 32, temperature of 36.8C and you hear crackles in both lung bases. He denies any palpitations, chest pain, and has not been drinking alcohol. Which of the following would you expect to find?
orthopnea
A 70 year old man presents with chest tightness, and increasing dyspnea and dizziness which began a day ago. They have a slow rising carotid pulse and systolic murmur which radiates to the carotids. No calf tenderness is noted.
Which diagnostic intervention will be most useful?
Echocardiogram
Causes of Sudden Onset Breathlessness
PE
Pneumothorax
Anaphylaxis
Inhalation of foreign body
Causes of Orthopnea or PND
Heart Failure aka pulmonary oedema COPD Asthma Cardiac arrhythmia Resp Muscle weakness Acute retention of urine with reactive pulmonary oedema
Causes of acute breathlessness, wheeze +/- cough
exacerbation of asthma exacerbation of COPD Acute viral/bacterial bronchiolitis Acute LVF Anaphylaxis
