How to diagnose pulmonary dyspnea causes

How to diagnose pulmonary dyspnea causes

Dyspnea is the medical term for wheezing, sometimes described as “air hunger”. It is an unpleasant feeling.

Shortness of breath can range from mild and transient to severe and prolonged. It is sometimes difficult to diagnose and treat shortness of breath, as there can be many different causes.

This is a common problem. According to the Cleveland Clinic Center for Continuing Education, 1 in 4 people who visit a doctor have dyspnea.

How to diagnose pulmonary dyspnea causes
Breathing problems can result from overexertion in healthy people.

Dyspnea can occur due to overexertion, time spent at high altitudes, or as a symptom of a number of medical conditions.

Signs that a person is experiencing shortness of breath include:

  • shortness of breath after exercise or due to a medical condition
  • feeling of choking or shortness of breath due to breathing difficulties
  • heavy breathing
  • stiffness in the chest
  • fast, shallow breathing
  • palpitations
  • panting
  • cough

If your wheezing occurs suddenly or if your symptoms are severe, it could be a sign of a serious medical condition.

An episode of dyspnea is not always directly related to an individual’s health. A person may feel breathless after intense physical exertion, when traveling at high altitudes or during large changes in temperature.

However, shortness of breath is usually associated with health problems. Sometimes it’s just a case of being out of shape and exercise can relieve symptoms. But shortness of breath can be a sign of a serious health problem.

According to Dr. Steven Wahls, the most common causes of dyspnoea are asthma, heart failure, chronic obstructive pulmonary disease (COPD), interstitial lung disease, pneumonia, and psychogenic problems that are usually associated with anxiety.

If wheezing occurs suddenly, it is referred to as an acute episode of wheezing.

Acute dyspnea can be caused by:

  • asthma
  • arch
  • pneumonia
  • choking or inhaling anything that obstructs the airways
  • allergic reactions
  • anemia
  • serious loss of blood, resulting in anemia
  • exposure to dangerous levels of carbon monoxide
  • cardiac arrest
  • hypotension, which is low blood pressure
  • pulmonary embolism, which is a blood clot in a pulmonary artery
  • collapsed lung
  • hiatal hernia

Dyspnea is also common among people with terminal illness.

If a person experiences shortness of breath for more than a month, the condition is called chronic shortness of breath.

Chronic dyspnea can be caused by:

  • asthma
  • COPD
  • heart problems
  • obesity
  • interstitial lung fibrosis, a disease that causes scarring of the lung tissue

Some additional lung conditions can also cause shortness of breath.

  • croup
  • traumatic lung injury
  • lung cancer
  • tuberculosis
  • pleurisy, inflammation of the tissues surrounding the lungs
  • pulmonary edema when too much fluid builds up in the lungs
  • pulmonary hypertension, where blood pressure rises from the arteries to the lungs
  • sarchidosi, quando nei polmoni crescono gruppi di cellule infiammatorie

Shortness of breath has also been linked to the following heart problems:

  • cardiomyopathy, a series of diseases that affect the heart muscle
  • heart rhythm problems
  • cardiac arrest
  • pericarditis, in which the tissue surrounding the heart becomes inflamed


How to diagnose pulmonary dyspnea causes
Dyspnea is a symptom of asthma.

Environmental pollutants such as chemicals, fumes, dust, and smoke can make breathing difficult for people with breathlessness.

People with asthma may find that exposure to allergens such as pollen or mold may trigger episodes of dyspnea.

Some contaminants, such as smoke, are self-administered and can be prevented.

COPD refers to different obstructive lung diseases. These include emphysema and chronic bronchitis.

All of these conditions make breathing much more difficult.

Not everyone with dyspnea has COPD, but 90 percent of people with COPD were tobacco smokers at one point, according to the COPD Foundation.

Your doctor will look at you and listen carefully to your lungs to diagnose shortness of breath. You can do a lung function test, called spirometry, to measure how much air you can breathe in and out of your lungs and how fast you can do it. This can help diagnose asthma and COPD.

Your doctor will look at you and listen carefully to your lungs to diagnose shortness of breath. You can do a lung function test, called spirometry, to measure how much air you can breathe in and out of your lungs and how fast you can do it. This can help diagnose asthma and COPD.

Other tests you may have include:

  • Pulse oximetry. A device is attached to the finger or earlobe and the light on it measures the amount of oxygen in the blood.
  • Blood analysis.
  • Chest x-ray or computed tomography (CT)
  • Electrocardiogram (ECG) This measures electrical signals from your heart to see if you are having a heart attack. It also shows how fast your heart is beating and if it has a healthy rhythm.

Reviewed by Brunilda Nazario on April 3, 2020.

UpToDate: "Educazione del paziente: dispnea (dispnea) (oltre le basi)"

Wonderopolis: "Quanti respiri fai ogni giorno?"

Medico di famiglia americano: "Zadyszka".

American Chest Society: "Senza fiato".

UpToDate: "Educazione del paziente: dispnea (dispnea) (oltre le basi)"

Wonderopolis: "Quanti respiri fai ogni giorno?"

Medico di famiglia americano: "Zadyszka".

American Chest Society: "Senza fiato".

In this article

  • When should i see a doctor?
  • Tests to diagnose shortness of breath

Each year, between 25% and 50% of people in the U. S. see a doctor for shortness of breath. You may have felt it too: the unpleasant feeling you get when you seem not to have enough air.

It’s a common symptom, and one that’s usually harmless — the result of a tough workout or a stressful day. But it can also be a sign that you have another health problem, such as arch, a lung infection like pneumonia, asthma, or heart disease.

How do you know what’s going on? Your doctor can do some basic tests to help you get to the bottom of shortness of breath.

When should i see a doctor?

Jeśli duszność powstrzymuje cię od wykonywania codziennych czynności, to wystarczający powód, aby croupzwonić do lekarza. But definitely make an appointment if you have breathing problems and any of these symptoms:

  • Out of breath when you rest or lie down
  • Fever, chills, night sweats
  • A fast, throbbing heartbeat
  • panting

Tests to diagnose shortness of breath

Podczas wizyty lekarz croupa Ci kilka pytań dotyczących Twojej historii medycznej i przeprowadzi badanie fizykalne. Ciò può includere ascoltare il tuo cuore e i tuoi polmoni per segni di congestione, mormorii o altri sintomi insoliti.

The test results could lead them to order some tests to find out what else could be causing their breathing problems.

Chest X-ray. It can show the doctor signs of conditions such as pneumonia or other heart and lung problems. It’s painless and easy – a radiologist can do this in about 15 minutes.

Oxygen test. Also called pulse oximetry, it helps doctors measure the amount of oxygen in the blood. They place a sensor on the finger similar to a clothespin that uses light to detect oxygen. Apart from the pressure of the sensor, you will not feel anything.

Electrocardiography (ECG) You can do this test in a doctor’s office or hospital. A technician will attach small electrodes to the chest with gel or tape, and the machine will measure the electrical impulses that make your heart beat. An EKG can show the doctor if blood flow to the heart is impaired.


Pulmonary function test. This measures how well your lungs are working and tells your doctor if something is blocking or preventing them from using air properly. It can also show how well your lungs can carry and use oxygen. One type of lung function test is called spirometry. Breathe into the mouthpiece that connects to the machine and measures lung capacity and airflow. Your doctor may also ask you to pack in a box that looks like a phone booth to check your lung capacity. This is called plethysmography. Each of these tests helps your doctor diagnose problems such as asthma, emphysema, or COPD.

Blood test. Your doctor or nurse will use a needle to draw blood from a vein in your arm and send it to a laboratory for testing. The results can tell them whether or not conditions such as anemia or cardiac arrest are making you short of breath.

Jeśli duszność jest ciężka lub towarzyszą jej inne objawy, takie jak splątanie, ból w klatce piersiowej, ból szczęki lub ból w ramieniu, natychmiast croupzwoń pod numer 911.


Cleveland Clinic Lifelong Learning Center: “Spirituality. “

Medycyna Johnsa Hopkinsa: "Krótki oddech."

Podręczniki firmy Merck: "Skrócenie oddechu."

American Lung Association: "Diagnozowanie i leczenie duszności."

Fundacja Chest: "Testy i diagnoza."

Cleveland Clinic: “Chest X-Ray "and" Body Plethysmography (Pulmonary Function Test)

Amerykańska Akademia Lekarzy Rodzinnych: "Diagnostyczna ocena duszności."

Mayo Clinic: “Electrocardiogram (ECG or ECG) "

The Johns Hopkins Medicine Health Library: Pulmonary Function Tests. “


  • 1 Krankenhaus Bad Oeynhausen, Mühlenkreiskliniken AÖR, Wielandstr. 28, 32545, Bad Oeynhausen, Germany, Jost. Niedermeyer @ muehlenkreiskliniken. de.
  • PMID: 26129864
  • DOI: 10.1007 / s00108-015-3692-1
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  • 1 Krankenhaus Bad Oeynhausen, Mühlenkreiskliniken AÖR, Wielandstr. 28, 32545, Bad Oeynhausen, Germany, Jost. Niedermeyer @ muehlenkreiskliniken. de.
  • PMID: 26129864
  • DOI: 10.1007 / s00108-015-3692-1


The subjective perception of pulmonary dyspnea varies with behavioral and physiological responses. Acute pulmonary dyspnea is the most common symptom of diseases of the airways and the lungs and the differential diagnosis includes harmless causes, such as lack of training as well as acute life-threatening diseases, such as thromboembolism, obstruction of the upper or lower airway, pneumonia, pulmonary hemorrhage and pneumothorax. Most cases of chronic pulmonary dyspnea result from asthma, Chronic obstructive pulmonary disease (COPD), pulmonary arterial hypertension, pulmonary fibrosis and pleural disorders. Wysłuchanie “języka duszności” pacjenta może już być wskazówką do diagnozy. Lo screening iniziale comprende radiografia del torace, spirometria, emocromo completo e un pannello metabolico di base. Measurement of brain natriuretic peptide levels may help to exclude cardiac arrest in COPD and D-dimer testing may help rule out pulmonary embolisms. La tomografia computerizzata del torace è la procedura di imaging più appropriata nella diagnosi di embolia polmonare e malattia polmonare interstiziale. L’ecocardiografia e il cateterismo del cuore destro possono essere necessari per diagnosticare l’ipertensione arteriosa polmonare.

Pulmonary edema is an abnormal accumulation of fluid in the lungs. This fluid buildup leads to shortness of breath.


Pulmonary edema is often caused by congestive cardiac arrest. When the heart is unable to pump efficiently, blood can flow back into the veins that carry blood through the lungs.

As the pressure in these blood vessels rises, fluid is expelled into the air spaces (alveoli) in the lungs. This fluid reduces the normal flow of oxygen through the lungs. These two factors combine to make you gasp.

How to diagnose pulmonary dyspnea causes

Congestive cardiac arrest that leads to pulmonary edema may be caused by:

  • A heart attack or any heart disease that makes the heart muscle weak or stiff (cardiomyopathy)
  • Leaking or constricted heart valves (mitral or aortic valves)
  • Sudden and severe hypertension (hypertension)

Pulmonary edema can also be caused by:

  • Some medications
  • High altitude exposure
  • Kidney failure
  • Restricted arteries that supply blood to the kidneys
  • Lung damage from poisonous gas or severe infection
  • Serious injuries


Symptoms of pulmonary edema may include:

  • Cough with blood or blood foam
  • difficulty breathing when lying down (orthopnea)
  • Uczucie "głodu powietrza" lub "tonięcia" (to uczucie nazywa się "napadową dusznością nocną", jeśli powoduje, że budzisz się 1 do 2 godzin po zaśnięciu i walczysz or złapanie oddechu)
  • Grunting, gurgling, or panting sounds with breathing
  • Difficulty speaking in full sentences due to shortness of breath

Other symptoms may include:

  • Restlessness or anxiety
  • A decrease in alertness
  • Swelling in the legs or abdomen
  • Pale skin
  • Sweating (excessive)

Exams and tests

A healthcare professional will perform a thorough physical exam.

The service provider will listen to your lungs and heart with a stethoscope to check:

  • Abnormal heart sounds
  • A crackling sound in the lungs called rales
  • Increased heart rate (tachycardia)
  • Rapid breathing (tachypnea)

Other things that can be seen on the exam are:

  • Swelling in the legs or abdomen
  • abnormalities in the veins in the neck (which may indicate that there is too much fluid in the body)
  • Pale or blue skin color (pale or cyanotic)

Possible tests include:

  • Blood chemistry
  • Blood oxygen levels (oximetry or blood gas analysis)
  • Chest X-ray
  • Complete blood count (CBC)
  • An echocardiogram (ultrasound of the heart) to check for heart muscle problems
  • Un elettrocardiogramma (ECG) per cercare segni di infarto o heart rhythm problems


Pulmonary edema is almost always treated in the emergency room or hospital. You may need to be in an intensive care unit (ICU)

  • Oxygen is administered through a face mask or small plastic tubes inserted into the nose.
  • A breathing tube can be placed in the trachea so you can attach a breathing device (respirator) if you can’t breathe on your own.

The cause of the swelling must be quickly identified and treated. For example, if a condition has caused a heart attack, it should be treated immediately.

Medicines that can be used include:

  • Diuretics to remove excess fluids from the body
  • Medicines to strengthen the heart muscle, control the heart rate or relieve pressure on the heart
  • Other medicines when cardiac arrest is not the cause of the pulmonary edema

Perspectives (forecast)

The outlook depends on the cause. The condition can improve rapidly or slowly. Some people may need to use the respirator for a long time. If left untreated, the condition can be life-threatening.

When to see a doctor

Udaj się na pogotowie lub croupzwoń pod numer 911 lub lokalny numer alarmowy, jeśli masz problemy z oddychaniem.


If you have a disease that could cause pulmonary edema or heart muscle weakness, be sure to take all medications as prescribed.

Eating a healthy, low-salt, low-fat diet and controlling other risk factors can reduce the risk of developing this condition.

Alternative names

pulmonary congestion; Lung water; pulmonary congestion; Heart failure – pulmonary edema


  • Lungs
  • Respiratory System


Felker GM, Teerlink JR. Diagnosis and management of acute cardiac arrest. In: Zipes DP, Libby P, Bonow RO, Mann DL, Tomaselli GF, Braunwald E, ed. Braunwald heart disease: a textbook on cardiovascular medicine. 11th ed. Philadelphia, Pennsylvania: Elsevier; 2019: cap. 24.

Matthay, Murray JF. Pulmonary edema. In: Broaddus VC, Mason RJ, Ernst JD et al., Eds. A textbook of respiratory medicine by Murray and Nadel. 6th ed. Philadelphia, Pennsylvania: Elsevier Saunders; 2016: cap. 62.

Rogers JG, O’Connor CM. Heart failure: pathophysiology and diagnosis. In: Goldman L, Schafer AI, ed. Goldman-Cecil Medicine. 26th ed. Philadelphia, Pennsylvania: Elsevier; 2020: cap. 52.

With the screenplay by Bel Marra Health
| –> Health News | –> Published on January 31, 2018

A pulmonary infarction is defined as the death of one or more segments of lung tissue due to a lack of blood supply. This dead tissue is known as a lung infarction. Reduced or deficient blood flow is usually caused by blocking a blood vessel that serves the lungs. This blockage can manifest as a blood clot or air bubbles in the bloodstream known as an embolism. This blockage can also be caused by a clot that has formed in the blood vessel itself and remains at the site of its formation (thrombus). People with healthy lungs generally survive these blockages because blood reaches its destination via alternative pathways. However, a person with diseased, infected, or clogged lungs is more likely to develop a pulmonary infarction after a blood vessel has been blocked. These heart attacks heal after two to three weeks, in which dead tissue is replaced with scar tissue.

What are the causes and symptoms of a pulmonary infarction?


On a large scale, the most common cause of a pulmonary infarction is a blood clot traveling to the lungs known as a pulmonary embolism. Istnieją jednak inne schorzenia, które mogą powodować ten problem: rak, choroby autoimmunologiczne, takie jak toczeń, anemia sierpowatokrwinkowa, infekcje i choroby płuc, takie jak amyloidoza. Pomimo tych wielu przyczyn zawał płuca jest rcroupki, ponieważ tkanka płuc ma trzy źródła gromadzenia tlenu: tętnicę płucną, tętnicę oskrzelową i same pęcherzyki płucne. This has led specialists to observe that pulmonary infarctions are more common in people who have a significant underlying lung disease (e. g. Chronic obstructive pulmonary disease)


The symptoms of pulmonary infarction are variable but are generally accompanied by the cough up of blood (hemoptysis), fever, shortness of breath (dyspnea), and chest pain in the area of the issue when breathing in (pleurisy) U niektórych osób zawał płuca w ogóle nie daje żadnych objawów. In fact, the condition is sometimes diagnosed as a chance discovery when a mass is detected on a routine chest X-ray. The first signs a patient may experience are an effort to get out of bed, make some effort, or reposition themselves. They may feel anxious and suffer from any of the following symptoms:

  • Sharp chest pain radiating to the shoulder (pleural pain)
  • Blood in the sputum
  • Coughing, or cough up blood (hemoptysis)
  • Abdominal pain
  • Respiratory difficulties
  • Rapid heartbeat (tachycardia)
  • Reduced breathing noises
  • Constant hiccups
  • Extreme sweating
  • Pleural rubbing
  • jaundice or jaundice
  • Boring should heart on the chest drums
  • State of shock
  • Increased white blood cell count and sedimentation rate in a blood test

How to diagnose and treat a pulmonary infarction

There are several tests that doctors can use to diagnose a pulmonary infarction. These include arterial or capillary blood gases, D-dimero tests, blood tests, chest X-ray, chest CT, CT pulmonary angiography, ventilation / perfusion scan, MRI, and echocardiography. Ordinary X-rays are also used, and in these tests the results include a wedge-shaped hump with no air bronchograms in the lower lobes. Computed tomography would reveal, among other things, the same shapes, as well as convex edges with a halo mark.

The most definitive diagnostic method available is pulmonary angiography, which is used with increasing frequency, efficacy and safety. The procedure has some risks and should not be used indiscriminately, but it is very useful in selected patients, especially those considered for pulmonary embolectomy. Angiography helps confirm the diagnosis of pulmonary embolism and determine the extent and location of the embolism, which is important information when surgery is needed.

People seeking treatment for a pulmonary infarction will receive supportive care and treatment for their underlying disease. Aspects of supportive care include maintaining sufficient blood oxygenation by administering it and controlling pain to reduce discomfort while breathing. If the blood oxygen isn’t enough, the patient may need to be intubated and provided with a ventilator. Each case may require additional or alternative treatment, but aggressive treatment should be used in people who have seizures or sickle cell infections. If the cause is cancer, specific treatment options should be considered. However, if the root cause is pulmonary embolism, treatment would involve administering an anticoagulant drug followed by administering an oral anticoagulant for several days. If the underlying cause is more serious, fibrinolytic drugs may be needed to dissolve the clot blocking blood flow.


Dyspnea or wheezing is a commonly reported symptom in ICU and outpatient care units. Causess of dyspnea include pulmonary (e. g., pneumonia, asthma exacerbation), cardiac (e. g., acute coronary syndrome, congestive cardiac arrest), toxic-metabolic (e. g., metabolic acidosis, medications), and upper airway (e. g., epiglottitis, foreign body) pathologies. When first reported, it is important to immediately evaluate the patient for urgent or life-threatening causes of dyspnea with history, physical examination, and diagnostic tests. Once life-threatening immediate causes have been ruled out, a more detailed patient history should be collected and further investigations performed to narrow the differential diagnoses.


Approachto management

  1. ABCDE survey
  2. Establish intravenous access, heart rate monitoring, and pulse oximetry.
  3. Start with oxygen supplementation as needed.
  4. Assess the need for assisted ventilation and airway management.
  5. Stabilize cardiovascular function (eg, IV fluid resuscitation)
  6. Eseguire l’anamnesi, l’esame e la diagnostica mirati per escludere cause reversibili pericolose per la vita (vedere "Diagnostics" di seguito)
  7. After ruling out life-threatening causes:
    • Perform a detailed patient history and clinical examination (see Lung Exam Results Overview)
    • Consider additional diagnostic tests (eg, peak flow, PFT)
  8. Treat the root cause.

Red flags for shortness of breath

  • Dyspnea at rest
  • Signs of increased respiratory work
  • Chest pain
  • Diaphoresis
  • Decreased level of consciousness or agitation
  • Screeching
  • Distant heart sounds
  • New heart murmur
  • The wrist paradox
  • Cyanosis
  • Focal neurological deficits
  • Hypotension
  • Respiratory acidosis

Causess immediatamente pericolose per la vita

  • An emphysema of tension
  • Pulmonary embolism
  • ACS
  • Cardiac tamponade
  • Foreign bodies in the respiratory tract
  • Angioedema
  • Anaphylaxis
  • Severe COPD exacerbation
  • Severe asthma exacerbation
  • Acute congestive cardiac arrest
  • Cardiac arrhythmia
  • Acute respiratory distress syndrome
  • Alveolar hemorrhage
  • Deep space infections of the neck
  • Acute valvular dysfunction
  • Hit
  • Diabetic ketoacidosis


Diagnostic management should be based on the likelihood of a preliminary test of the diagnoses under consideration. The following list includes some commonly used diagnostic tools that can help diagnose or rule out a possible etiology in patients with acute dyspnea.

Pretreatment [1]

Lab test

  • ABG
  • Troponin
  • D-dimer
  • BNP or pro-BNP
  • CBC
  • BMP


  • ECG
  • Chest X-ray
  • Chest CT with IV contrast (PE protocol)
  • TTE
  • SOON

Further diagnoses to consider

  • Respiratory virus panel
  • Blood and sputum cultures
  • Negative inspiratory flow
  • Peak flow and PFT
  • X-ray of the ribs
  • CT of the brain without intravenous contrast
  • Lumbar puncture
  • Serum levels of salicylate
  • TSH and T4 free
  • CT of the neck with contrast IV

Causess polmonari

Causess cardiache

Causess del tratto respiratorio superiore

Toxic-metabolic and other causes

Anything that can cause metabolic acidosis (eg DKA, lactic acidosis, salicylate toxicity) can also cause acute dyspnea.

Differential diagnosis

The differential diagnoses listed here are not exhaustive.

How to diagnose pulmonary dyspnea causes

Dyspnea, sudden and severe breathlessness, is a common symptom in the emergency room and, above all, one of the most frequent causes of hospital visits. There are a wide range of causes of dyspnea, including cardiac, pulmonary, metabolic, or shock, which make it difficult for emergency room doctors to diagnose and treat the condition.

Because the diagnosis is timely Important?

Treatment niewłaściwej przyczyny u pacjenta z dusznością może spowodować szybkie pogorszenie. Therefore, it’s crucial to identify the underlying cause and initiate prompt and appropriate treatment. It could save the lives of these patients.

A research paper published in Herz aimed to evaluate how pocket echo can speed up diagnosis time in patients with acute dyspnea in ED. W podsumowaniu stwierdzono: “Vscan to praktyczne, przenośne urządzenie, które zapewnia szybkie informacje diagnostyczne. One third of patients had significant scan results that can help diagnose and prevent misdiagnosis.”

Help us find out the cause

Traditional tests, which include brain natriuretic peptide, a chest X-ray, CT pulmonary angiography, or formal echocardiograph can take time to perform and generate results.

Using a portable ultrasound to diagnose the cause of shortness of breath can aid in a quick emergency diagnosis and speed up the implementation of the treatment plan.

A study published in the Journal of Hospital Medicine trained internal medicine inmates to perform a bedside ultrasound of the lungs using pocket ultrasound. Badanie wykazało, że “USG płuc wykonywane przez pensjonariuszy za pomocą ultrasonografii kieszonkowej poprawiło dokładność diagnostyczną duszności. Two residents undergoing extensive training showed a complete increase in diagnostic accuracy.”

Differentiating types

There are many potential causes of dyspnea, and it’s essential to differentiate between them to implement early treatment. One of the key diagnostic challenges is to distinguish between cardiac (e. g., acute cardiac arrest) and pulmonary causes. The accuracy of the diagnosis can be improved by using manual pulmonary-heart-inferior vena cava (LCI) ultrasound.

A study in Cardiovascular Ultrasound concluded that “rapid evaluation by LCI integrated ultrasound is extremely accurate for differentiating acute dyspnea due to acute cardiac arrest syndromes (AHFS) from that caused by primary pulmonary disease in the emergency setting.”

This suggests that integrated LCI ultrasound may be a useful tool to accelerate diagnosis and thus implement timely decision and management plans at the HED.

Help improve patient care

Overall, using manual ultrasound to diagnose the underlying cause in patients with dyspnea can be an easy-to-learn skill, quick to use, and capable of supporting faster treatment decisions than other options. This can help improve patient care through timely diagnosis and treatment.