ABSTRACT
This chapter presents a framework for the evaluation of chronic dyspnea, defined as that which has lasted at least 1 month. Inspection, auscultation, and percussion of the thorax are all important means of investigating mechanisms of chronic dyspnea. Certain coexistent symptoms tend to reflect specific causes of chronic dyspnea and therefore enrich the history-taking process when discussed collectively. Spirometry is perhaps the single most important diagnostic test for chronic dyspnea. Fortunately, the cause of dyspnea can be explained most of the time by obtaining a thorough history and physical examination and by performing a limited number of diagnostic tests. During the dyspnea workup, the clinician is obliged to estimate the likelihood of each candidate diagnosis within his or her patient panel. Patients may describe that certain body positions mitigate or antagonize their dyspnea. Some of the factors have rightfully been regarded as highly specific for certain diseases, while others are less discriminative.
