FindingsCondition
History
Dyspnea on exertionCardiac or pulmonary disease, deconditioning
Dyspnea during restSevere cardiopulmonary disease or noncardiopulmonary disease (e.g., acidosis)
Orthopnea, paroxysmal nocturnal dyspnea, edemaCongestive heart failure, chronic obstructive pulmonary disease
MedicationsBeta blockers may exacerbate bronchospasm or limit exercise tolerance. Pulmonary fibrosis is a rare side effect of some medications
SmokingEmphysema, chronic bronchitis, asthma
Allergies, wheezing, family history of asthmaAsthma
Coronary artery diseaseDyspnea as anginal equivalent
High blood pressureLeft ventricular hypertrophy, congestive heart failure
AnxietyHyperventilation, panic attack
Lightheadedness, tingling in fingers and perioral areaHyperventilation
Recent traumaPneumothorax, chest-wall pain limiting respiration
Occupational exposure to dust, asbestos or volatile chemicalsInterstitial lung disease
Physical examination
AnxietyAnxiety disorder
Nasal polyp, septal deviationDyspnea due to nasal obstruction
Postnasal dischargeAllergies/asthma
Jugular vein distentionCongestive heart failure
Decreased pulse or bruitsPeripheral vascular disease with concomitant coronary artery disease
Increased anteroposterior chest diameterEmphysema
WheezingAsthma, pulmonary edema
RalesAlveolar fluid (edema, infection, etc.)
TachycardiaAnemia, hypoxia, heart failure, hyperthyroidism
S3Congestive heart failure
MurmurValvular dysfunction
Hepatomegaly, hepatojugular reflux, edemaCongestive heart failure
Cyanosis, clubbingChronic severe hypoxemia