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

Footnotes

  1. Pratter MR, Abouzgheib W, Akers S, Kass J, Bartter T. An algorithmic approach to chronic dyspnea. Respir Med. 2011 Jul;105(7):1014-21. doi: 10.1016/j.rmed.2010.12.009. Epub 2011 Jan 7. PMID: 21215608. https://pubmed-ncbi-nlm-nih-gov.wake.idm.oclc.org/21215608/ 2 3 4 5 6