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Differentiation between pulmonary and cardiac causes of Dyspnoea

Dyspnoea due to pulmonary aetiology has the following features
  • Cough with expectoration precedes dyspnoea.
  • Wheeze or stridor.
  • Pleuritic chest pain.
  • Pyrexia.
  • Seasonal variation.
  • Weight loss.
  • Cyanosis (++ or +++).
  • Progression over many years.
  • Response to oxygen, bronchodilalors.
  • Absence of obvious cardiac disease.
Dyspnoea due to cardiac aetiology has the following features
  • PND and orthopnoea.
  • Dyspnoea precedes cough with expectoration.
  • Associated angina, syncope, palpitation: hypertension.
  • Rapid progression of symptoms.
  • Little or no cyanosis {+).
  • Response to diuretics and digoxin.
  • Physical signs of cardiac disease.