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Principles of therapeutic approach 2007


D. Kostadinov

Bronchology Department, St. Sofia University Pulmonary Diseases Hospital, Sofia

Summary: Dyspnea is an inevitable companion of a series of diseases such as advanced malignant diseases, degenerative neuromuscular or cardiovascular diseases, excessive obesity, and neuropsychic disorders. Inspiratory, expiratory and mixed types of dyspnea are distinguished. It is very important to differentiate acute from chronic dyspnea. Acute dyspnea is a dramatic condition, which requires urgent diagnosis and management. Chronic dyspnea is more difficult in terms of differential diagnosis because there is no marked correlation between the objectively measured respiratory efforts and the subjective respiratory complaints of the patient. Some diseases of the larynx, the tumors or strictures of the trachea or main stem bronchi, the aspiration of foreign body cause inspiratory dyspnea. Such a shortness of breath may appear only during exercise or during rest but it may very rapidly lead to a life-threatening condition of asphyxia as well. Upon inhalation of a foreign body, the dyspnea appears acutely and may rapidly lead to asphyxia. The diagnosis of inspiratory dyspnea caused by diseases of the larynx or the trachea includes history, physical exa­mination, image diagnostics, ventilation parameters, blood gases, and endoscopic examination. The rapid and precise information, particularly in case of an inspiratory dyspnea, is necessary for the direct management of the shortness of breath by means of the bronchologic examination. It is the gold standard in diagnostics and management of dyspnea.

Key words: dyspnea, obstructive diseases, larynx, trachea, main stem bronchus, clinic, diagnosis, management

Address for correspondence:
Ass. Prof. Dimitar Kostadinov, MD, St. Sofia University Pulmonary Diseases Hospital, Bronchology Department,
19 Acad. Ivan Geshov blvd., Bg – 1431 Sofia, tel. 80-54-215, GSM +359 0898 416-664

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