An Algorithmic Approach to Chronic Dyspnea
Intro
- PFT: COPD and asthma
- CXR: lung and pleural disorder
- Labs: anemia, thyroid disorder, and heart failure
Protocol
- Move from tier 1 to 2 then to 3 if no clear diagnosis
- Stop at any tier if there's clear diagnosis
- tier 2 does not include echo
- if CPET points to cardiac: echo or stress echo
- Tier 3: Other organ focused testing includes chest CT, bronchoscopy, echo, nuclear stress, RHC based on previous results.
- Normal Tier 1 and 2 study suggest dyspnea is non-cardiorespiratory, and Tier 3 studies were not necessary1
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