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Breathlessness, Dyspnoea

Dear patients Thank you for your most interesting questions and thank you for trusting me to manage you health. Breathlessness Dyspnoea is the perception of breathlessness and may be exertional or, when more advanced, occur at rest. It may only occur when lying down (orthopnoea). Is the breathlessness a recent development? Is it episodic? Ask how far the patient can walk without stopping (often an unreliable history) and how many pillows he/she uses in bed at night (in orthopnoea). Look for digital clubbing, central cyanosis and chest wall deformities. Pulmonary causes Pneumonia, e.g. bacterial, viral. Bronchitis—acute or chronic. COPD. Acute asthma. Pneumothorax—even a small pneumothorax may acutely exacerbate dyspnoea in patients with pre-existing chronic pulmonary disease. Interstitial lung disease—e.g. sarcoidosis, fibrosing alveolitis, extrinsic allergic alveolitis, pneumoconiosis. Bronchogenic carcinoma. Foreign body obstructing bronchus (esp. children—peanut in rig