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Table 10.2

Urgent Investigation in Acute Breathlessness

  • Chest X-ray
  • Arterial blood gases, pH and lactate if oxygen saturation is <90%, sepsis is suspected or diagnosis is unclear
  • ECG (except in patients under 40 with pneumothorax or acute asthma)
  • Echocardiogram if suspected cardiac disease
  • Full blood count
  • Plasma sodium, potassium and creatinine
  • Blood glucose
  • Plasma biomarkers:
    • Fibrinogen degradation products (d-dimer) if there are risk factors for venous thromboembolism (Table 56.1)
    • BNP or NT-proBNP if clinical features of cardiac disease or abnormal ECG, and in patients with suspected exacerbation of COPD
    • Troponin if clinical features of cardiac disease or abnormal ECG
    • C-reactive protein if possible sepsis