investigations

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In patients with acute dyspnoea the following investigations can be done:

  • pulse oximetry - to determine the level of oxygenation
  • chest radiographs - to rule out pneumothorax, pneumonia, COPD, pulmonary oedema, or congestive heart failure
  • electrocardiography - to identify ischemia, left ventricular hypertrophy and arrhythmia
  • bedside spirometry (to obtain a PEFR) - for exacerbation of asthma or COPD (1)

work-up for patients with chronic dyspnoe include

  • initial diagnostic
    • chest radiography - to identify congestive heart failure, pleural disease, chest wall abnormalities
    • electrocardiography - to look for evidence of arrhythmia, cardiac ischemia, ventricular hypertrophy or pericardial disease
    • full blood count - to check for anaemia
    • spirometry - to identify obstructive lung disorders from restrictive lung disorders
  • if diagnosis is still not evident further investigations can be carried out:
    • echocardiography - to diagnose cardiac causes of chronic dyspnoea (especially in patients with suspected heart failure)
    • brain natriuretic peptide (BNP) - to diagnose heart failure
    • lung function tests - to identify restrictive lung and obstructive lung disorders (2)

Reference:

Last reviewed 01/2018