Breathlessness Differentials

Question 1

What are the main causes of wheeze?

Answer 1

Asthma, COPD, heart failure, anaphylaxis.

Question 2

What are the main causes of stridor?

Answer 2

Foreign body/tumour, acute epiglottitis, anaphylaxis, trauma.

Question 3

What are the main causes of crepitations?

Answer 3

Heart failure, pneumonia, bronchiectasis, fibrosis.

Question 4

What are the causes of acute dyspnoea?

Answer 4

1. Upper airway obstruction
2. Lower airway disease
3. Parenchymal lung disease
4. Other resp causes - pneumothorax, pleural effusion, PE, acute chest wall injury
5. Cardiac causes - acute pulmonary oedema, ACS, tamponade, arrhythmias, acute valvular heart disease
6. Other - metabolic acidosis, anxiety/panic attack

Question 5

What can cause an acute upper airway obstruction?

Answer 5

1. Inhaled foreign body
2. Anaphylaxis
3. Epiglottitis

Question 6

What can cause an acute lower airway disease?

Answer 6

1. Acute bronchitis
2. Asthma
3. Acute exacerbation of COPD
4. Acute exacerbation of bronchiectasis

Question 7

What are the respiratory causes of chronic dyspnoea?

Answer 7

1. Lung cancer
2. Bronchial carcinoma
3. Mesothelioma
4. Interstitial lung disease (sarcoidosis)
5. Bronchiectasis
6. Cystic fibrosis
7. Laryngeal stenosis
8. Tuberculosis

Question 8

What are the non-respiratory causes of chronic dyspnoea?

Answer 8

1. Severe anaemia
2. Obesity
3. Kyphoscoliosis
4. Neuromuscular disorders
5. Congestive heart failure
6. Coronary artery disease