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Breathlessness or dyspnoea is defined and the different kinds of diagnosis, symptoms and causes are discussed. The importance of communication for effective assessment and examination is highlighted.

Study objectives: The aim of this study was to investigate the relationship between high-resolution CT (HRCT) lung attenuation measurements, acquired under spirometric control of inspiratory and expiratory lung volume, and [...]

Background: Echocardiography and B-type natriuretic peptide (BNP) are diagnostic tests for congestive heart failure (CHF), but an emergency diagnosis can be difficult. Objective: To assess the diagnostic performance of BNP [...]

For the past week, a 16-year-old boy has had a progressively worsening dry, irritating cough; dyspnea on exertion; and intermittent fever (temperature up to 38.3°C [101°F]) and chills. During the [...]

Abbreviations: C(a-v)[O.sub.2]=arteriovenous [O.sub.2], content difference; Dco=diffusion of carbon monoxide; [PETCO.sub.2]=end-tidal carbon dioxide pressure; VD/VT =physiologic dead space/tidal volume; VE=minute ventilation; [VO.sub.2]=oxygen uptake; Δ[VO.sub.2],/ΔWR= Change in oxygen consumption/change in work rate [...]

Study objectives: Dyspnea is most commonly assessed by questioning patients about their subjective perception of shortness of breath during physical exertion. Although speech production is altered by pulmonary disease, it [...]

Study objectives: To compare arterial blood gas (ABG) and pulmonary gas exchange variables (alveolar-arterial oxygen pressure difference [P(A-a)[O.sub.2]] and physiologic dead space to tidal volume ratio [VDNT]) measured during incremental [...]

Objective: Evaluate the reliability and validity of a new version of the University of California, San Diego Shortness of Breath Questionnaire (SOBQ), a 24-item measure that assesses self-reported shortness of [...]

Interpretation of symptom-limited exercise testing requires analysis of a large body of simultaneously recorded cardiopulmonary data. Karlman Wasserman has recommended an algorithmic approach to interpretation (WA) that leads to a [...]

The validity and utility of physical examination maneuvers were determined in diagnosing congestive heart failure (CHF) in patients with acute dyspnea. Fifty one patients presented to the emergency room with [...]

CASE #3 The patient, a 76-year-old man with no known significant medical history, came to the ER with sudden onset of chest pain that had begun at 2 AM and [...]

A 45-year-old woman reports that for the past year she has experienced intermittent 'flip-flopping' in her chest. During these episodes, which last for about 10 minutes and occur every 7 [...]

The article discusses the key aspects and features of breathlessness and the definition, epidemiology and pathophysiology of the same. The increasing prevalence of breathlessness is making it vital for healthcare professionals to explain interventions to patients and carers and support them to manage the symptoms.

A 13-year old female was referred to hospital for severe dyspnoea (stage III NYHA), with an oedema of the face and the lower limbs. She was then steadily putting on weight and gained up to 5 kilogram's. The situation got worse and the patient referred to cardio vascular surgery. The interview indicated that there has never been a myxomatosis case in her family before. The physical examination revealed a worsening of the general health status and a clinical anaemia. However the pulse was regular, beating at 100 per minute; and the blood pressure was 100/60mmhg. There was no longer an oedema on the face, but the other bilateral pre-tibia oedema was still persistent and taking the gore. The examination also revealed a turgescence of the jugular veins and a hepatomegalia. The heart auscultation allowed a diagnosis of a pulmonary stenosis breath, which was not varying with the changes of postures. The patient did not present any neuro-endocrine clinical signs or any external skin problems. The chest cross section echocardiography revealed a cardiac tumour which implanted on the front lateral side of the right ventricle with an expansion into the pulmonary infundibulum. The patient was operated within 48 hours following her admission. The removal of the myxomatosis was achieved using technique of extra corporeal circulation (CEC). The heart was reached through a median sternotomy followed by a longitudinal right side atriotomy. The tricuspid valve was normal; the tumour was located across the tricuspid orifice. Time cross clamping was 15 minutes. The anatomy pathological examination showed a tumour myxomatosis-like tumour with two lobes measuring 4.2 x 2.3 centimeters. At its top there were zones and muscular tissue and hemorrhagic necrosis. The evolution was simple; the post operation scanning check ups were satisfactoryRight ventricle myxoma protruding into pulmonary artery is exceedingly rare. Obstruction of cardiac cavity is redoubtable complication of myxoma. We emphasize the importance of periodic follow up of young patient with echocardiography allowing early detection of recurrence., Introduction In cardiology tumours are very unusual and heart myxoma, which is generally a benign tumour, constitutes the most predominantly occurring cases. They actually represent 0.5 to 1 % of [...]

To link to full-text access for this article, visit this link: http://dx.doi.org/10.1016/j.amjmed.2009.04.023 Byline: Tobias Reichlin (a), Mihael Potocki (a), Tobias Breidthardt (a), Markus Noveanu (a), Sabine Hartwiger (a), Emanuel Burri (a), Theresia Klima (a), Claudia Stelzig (a), Kirsten Laule (a), Alexandre Mebazaa (a)(b), Michael Christ (a)(c), Christian Mueller (a) Keywords: Acute decompensated heart failure; B-type natriuretic peptide; Dyspnea; Prognosis; Uric acid Abstract: Uric acid was shown to predict outcome in patients with stable chronic heart failure. Its impact in patients admitted in the Emergency Department with acute dyspnea, however, remains unknown. Author Affiliation: (a) Department of Internal Medicine, University Hospital Basel, Switzerland (b) Department of Anesthesiology and Critical Care Medicine, Hopital Lariboisiere, Paris, France (c) Department of Internal Medicine, Klinikum Nurnberg, Germany Article Note: (footnote) Funding: This study was supported by research grants from the Swiss National Science Foundation (PP00B-102853), the Department of Internal Medicine, University Hospital Basel, the Swiss Heart Foundation, the Novartis Foundation, the Krokus Foundation, and the Astra-Zeneca Fonds. The sponsors had no role in study design, data analysis, or interpretation., Conflict of Interest: Dr. Mueller has received research support from the Swiss Heart Foundation, the Novartis Foundation, the Krokus Foundation, Abbott, Astra Zeneca, Biosite, Brahms, Roche, Siemens, and the Department of Internal Medicine, University Hospital Basel, as well as speaker's honoraria from Abbott, Bayer, Biosite, Brahms, Roche, and Dade Behring. Dr. Mebazaa reported being a consultant for Abbott, Orion Pharma, Bayer Pharma, and Sigma-Tau, and receiving honoraria from Guidant, Edwards Life Sciences, and Inverness. All other authors declared no conflict of interest., Authorship: All authors meet criteria for authorship, had full access to the data, participated in the preparation of the manuscript, and accept responsibility for the scientific content of the manuscript.

Pulmonary arteriovenous malformation's (PAVMs) are rare pulmonary vascular anomalies, occurring at increased frequency in patients with hereditary hemorrhagic telengactasia (HHT). PAVMs, in which left pulmonary artery communicates directly with a pulmonary vein, usually present with cyanosis. We discuss a case of an abnormal communication between pulmonary artery and left pulmonary vein presenting as congestive heart failure. Keywords: Pulmonary arteriovenous malformation, Congestive heart failure, Hereditary hemorrhagic telengactasia, Table of Contents Abstract Case History Discussion Conclusion References Case History A 77 year old female with history of hereditary hemorrhagic teangiectasia and recurrent epistaxis presented to the Emergency Department [...]

Is your patient short of breath? Don't miss CHF Appearances can be deceiving A patient complaining of shortness of breath may 'look good,' but the history and pulse oximetry reading [...]

Table of Contents Abstract Introduction Case Summary Discussion References Abstract A marked thyroid enlargement and upper airway compression is predominantly caused by benign diseases and can present as chronic dyspnea [...]

Table of Contents Abstract Introduction Case Presentation Discussion Conclusion References Abstract The straight back syndrome, consisting of loss of normal upper thoracic spinal curvature is not an uncommon entity. In [...]

Byline: Elkhalil. Alymlahi, R. Dafiri A-six-year-old girl presented with complaint of episodic dyspnoea. Physical examination showed marked splenomegaly and hepatomegaly. Cardiovascular and neurological examinations were normal. The chest radiograph showed [...]

Chronic breathlessness is a disabling and distressing symptom associated with a variety of chronic respiratory, cardiac, metabolic and systemic diseases. Some of the main causes of breathlessness are described and various methods of assessing and managing this symptom are discussed so that patients achieve the best possible quality of life.

Dyspnea or shortness of breath, a patient's subjective uncomfortable awareness that he's working too hard to breathe causes panic and feelings of impending doom. Common causes and assessment techniques for dyspnea and nursing measures to help patient breathe are discussed.

When used in conjunction with a clinical evaluation, rapid assessment of B-type natriuretic peptide (BNP) reduces the time to appropriate treatment and the hospital admission rate in patients who present [...]