Diagnostic Evaluation of Dyspnea

Detecting Dyspnea: Common Causes, Symptoms & Diagnostic Methods

Dyspnea, or shortness of breath, is a subjective sensation of respiratory discomfort. It can be acute or chronic and is usually a sign of underlying medical conditions, such as heart disease, lung disease, or even anxiety.

Since dyspnea is a symptom rather than an illness, its detection relies on both clinical observation and patient-reported symptoms.

Continue reading to learn how dyspnea is detected.

What is Dyspnea or Shortness of Breath?

Dyspnea refers to the sensation of not being able to get enough air, experiencing shortness of breath, chest tightness, or difficulty breathing. It is further associated with the symptoms of lung or heart problems however, it can also be sign of other conditions such as asthma, anxiety or allergies. Sometimes intense exercise or having a cold can also lead to a feeling of breathlessness.

Difference between Dyspnea and Shortness of Breath

Dyspnea and shortness of breath refer to the same condition, but ‘dyspnea’ is the clinical term used by healthcare professionals. However, dyspnea is a medical term used by health professionals to describe the feeling of not getting enough air.

What are the Key Signs of Dyspnea?

The experience of shortness of breath varies from person to person depending on its underlying cause. Sometimes, it comes with few other associated symptoms such as:

• Chest tightness
• Working hard to take a deep breath 
• Rapid breathing or heart rate
• Feeling like you need to force yourself to breathe deeply
• Wheezing or stridor (noisy breathing)

Causes of Shortness of breath (Dyspnea)

The Most frequent causes of dyspnea are heart and lung conditions. While shortness of breath can result from exercise or mild illness, persistent or severe dyspnea may indicate an underlying medical condition. 

How Do Doctors Identify Dyspnea?

Doctors use the following methods to identify dyspnea:

1 Patient History

Collecting a thorough medical history is the first and most vital step in diagnosing dyspnea. A healthcare worker will inquire about the following:

• When the breathing difficulty began
• What activities trigger or worsen it (e.g., walking, lying flat, climbing stairs)
• How long does it last
• Associated symptoms, like chest pain, coughing, or wheezing
• Lifestyle factors, such as smoking, exposure to allergens, or occupational hazards

This subjective data highlights potential causes and guides further investigation.

2 Physical Examination

After reviewing the patient's history, a thorough physical examination is conducted. The physician employs a stethoscope to listen for abnormal breath sounds in the lungs:

• Wheezing may suggest asthma or bronchitis
• Crackles (rales) may point to pneumonia or heart failure
• Decreased breath sounds could indicate a collapsed lung or pleural effusion

The doctor may also observe the person's breathing rate (respiratory rate), the use of accessory muscles, and any signs of cyanosis (a bluish discolouration of the skin indicating low oxygen levels).

3 Oxygen Saturation and Blood Tests

Pulse oximetry is a quick and painless test that measures the level of oxygen in the blood, known as oxygen saturation (Spo₂). A healthy person should have a level between 95% and 100%. However, an abnormal SpO₂ level indicates that the patient may not be receiving adequate oxygen.

In more complicated or uncertain instances, an arterial blood gas (ABG) study is performed. ABG provides precise data about oxygen, carbon dioxide, and pH levels in the blood, which assists in identifying respiratory failure or metabolic abnormalities.

4 Imaging Tests

If symptoms or physical signs suggest lung or cardiac involvement, imaging can be used:

• Chest X-rays can reveal pneumonia, heart failure, pleural fluid, or a collapsed lung.
• CT (computed tomography) scans provide better images to identify conditions such as pulmonary embolism, tumours, or interstitial lung disease.

5 Pulmonary Function Tests (PFTs)

These tests evaluate lung function. They measure lung volumes, airflow, and gas exchange. PFTs are especially important for diagnosing asthma, COPD (chronic obstructive pulmonary disease), or restrictive lung diseases.

6 Cardiac Evaluation

Since heart conditions may also cause dyspnea, electrocardiograms (ECG) and echocardiograms may be occasionally ordered. These tests will determine if there are rhythm disturbances or heart failure, which may restrict blood supply and oxygen delivery.

7 Exercise Testing

Exercise tolerance tests, also known as 6-minute walk tests, may be conducted in certain situations. These tests evaluate the lung and heart response to exertion and are helpful for chronic dyspnea.

Dyspnea detection involves not only identifying the symptom itself but also discovering its underlying cause. Whether the issue is pulmonary, cardiac, or psychological, early detection plays a crucial role in guiding proper treatment and enhancing quality of life.

At Star Health, we offer coverage for respiratory disease treatments under our Star Health Assure Insurance Policy. We also provide hassle-free claim settlements with reduced turnaround time across 14,000 network hospitals in India.

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