an awareness that an abnormal amount of effort is required for breathing
Questions to ask the breathless patient
- How long have you been short of breath? Is it getting worse?
- How did it start: suddenly or gradually? What was the patient doing when it started: lying down, running, walking?
- How much exercise can you do before your SOB stops you or slows you down? Can you walk up a flight of stairs?
- What brings it on? What alleviates it (e.g. posture, medication or oxygen)?
- Have you been woken at night by breathlessness or had to sleep sitting up?
- Is there a feeling of tightness in the chest when you feel breathless?
- Do you get wheezy in the chest? Cough?
- Is the feeling really one of difficulty getting a satisfying breath?
- Is it painful to take a big breath?
- Have you had a temperature?
- Have you had heart or lung problems in the past? previous episodes? Any allergies?
- Do you smoke? HX of medication.
- Are you often short of breath when you are anxious? Do you feel numbness and tingling around your lips when you are breathless?
- How has breathlessness interfered with any activities?
New York Heart Association classification:
- Class I Disease present but no dyspnoea or dyspnoea only on heavy exertion.
- Class II Dyspnoea on moderate exertion.
- Class III Dyspnoea on minimal exertion.
- Class IV Dyspnoea at rest.
Differential diagnosis of Dyspnea
