Approach to Patients with Shortness of Breath
FAM 530
Objectives
At the end of this session, students will be able to:
- Identify differential diagnosis for shortness of breath.
- Differentiate different phases of bronchial asthma.
- Discuss briefly about bronchial asthma in adults.
- Discuss briefly about bronchial asthma in children.
- Enumerate and discuss the importance of signs & symptoms.
- Investigate appropriately a patient with bronchial asthma.
- Advise initial management plan according to (SINA 2024).
- Identify long-term complications.
Definition
- Asthma is a common heterogeneous chronic disorder of the airways, characterized by variable, usually reversible and recurring symptoms related to one or more of airflow obstruction, bronchial hyper-responsiveness, and underlying inflammation.
- It is one of the most common chronic diseases in Saudi Arabia, affecting more than 2 million Saudis.
Case Scenario
- Khalid, a 14-year-old, comes to the clinic with the complaint of shortness of breath for one day duration.
- He is a known asthmatic patient for more than 8 years; he visits the A/E department frequently.
- His school performance is below average, with frequent absences from school due to his illness.
Physical Exam Results
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Physical exam: BP 130/78
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Pulse: 98 bpm
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RR: 20 /min
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SPO2: 97 %
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Chest exam shows prolonged expiration with expiratory wheezing all over. Heart and abdomen exam is normal.
DDS of SOB
Lung Diseases
- Asthma
- Bronchitis
- Chronic obstructive pulmonary disease
- Cystic fibrosis
- Emphysema
Disorders affecting breathing nerves and muscles
- Amyotrophic lateral sclerosis
- Guillain-Barré syndrome
- Multiple sclerosis
- Myasthenia gravis
- Parsonage Turner syndrome
- Eaton-Lambert syndrome
Disorders of the blood and metabolism
- Anemia
- Hypothyroidism
- Adrenal insufficiency
- Metabolic acidosis
- Sepsis
- Leukemia
Psychological conditions
- Anxiety disorders and panic attacks
- Acute myocardial infarction
- Congestive heart failure