Case review

Untangling chronic breathlessness in primary care

Case review

Untangling chronic breathlessness in primary care

Anthony P. Sunjaya, Leanne M. Poulos, Helen K. Reddel, Christine R. Jenkins

Figures

© microgen/stock.adobe.com model used for illustrative purposes only
© microgen/stock.adobe.com model used for illustrative purposes only

Abstract

Chronic breathlessness is a common diagnostic and management challenge in daily practice. Although it is often associated with respiratory or cardiac conditions such as chronic obstructive pulmonary disease (COPD) and heart failure, several less common and systemic causes are important differential diagnoses not to be missed in daily practice.

Key Points

  • More than 9% of Australian adults report breathlessness; clinically important breathlessness is associated with poor quality of life, depression and anxiety.
  • In most patients with chronic breathlessness, a systematic history and physical examination will guide the need for diagnostic investigations to rule out differential diagnoses or confirm a working diagnosis.
  • A systematic approach to diagnosis can start with easily performed, noninvasive tests, which lead to a diagnosis in around 70% of people.
  • If this approach does not result in a diagnosis and clear treatment approach, specialist referral should be considered.