DYSPNOEA

PULMONARY CAUSES [causing impaired ventilation]

upper airways obstruction [causes stridor]:

trauma

tumours

epiglottitis (H. influenzae in young children)

laryngeal oedema

laryngospasm

foreign body aspiration

abductor paralysis of vocal cords

lower airway obstruction:

tumours

chronic obstructive pulmonary disease

asthma

foreign body aspiration

inhalation of toxic fumes [may also cause pulmonary oedema]

cholinergic drugs

carcinoid syndrome

'space-occupying lesions' [causing decreased lung volume]:

pleural effusion(s)

tumours (bronchial, mesothelioma, etc.)

large hiatus hernia

haemothorax

pneumothorax

infection:

pneumonia

abscess

empyema

tuberculosis

bronchiectasis

interstitial lung disease [impaired gas transfer]:

lung fibrosis

lymphangitis carcinomatosa

other:

atelectasis

pneumonectomy

CARDIAC DISEASE [causing pulmonary oedema]

left-sided heart failure

valvular heart disease

arrhythmias

cardiomyopathy

pericardial effusion

cardiac shunts

IMPAIRED RESPIRATION

chest wall pathology:

kyphoscoliosis

rib fractures / flail chest

sternal compression

diaphragmatic compression or splinting:

pregnancy

subphrenic abscess

tense ascites

morbid obesity

diaphragmatic palsy

METABOLIC CAUSES [acidosis causing Kussmaul breathing]

uraemia

diabetic ketoacidosis

septicaemia

hepatic failure

HAEMATOLOGICAL DISEASE [causing decreased oxygen-carrying capacity of blood]

anaemia:

any cause of anaemia

abnormal haemoglobin:

haemoglobinopathies

thalassaemias

other:

polycythaemia

VASCULAR DISEASE [perfusion defects or VQ mismatch]

other:

pulmonary hypertension

pulmonary embolism / infarction

pulmonary arteriovenous shunts [dyspnoea worse when erect than supine]

OTHER / MISCELLANEOUS CAUSES

psychogenic

non-cardiogenic pulmonary oedema (ARDS)

thyrotoxicosis

myxoedema

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