Algorithm for the Evaluation of the Pt with Dyspnea - Flowchart

Algorithm for the Evaluation of the Pt with Dyspnea - Flowchart

Algorithm for the Evaluation of the Pt with Dyspnea - Flowchart Algorithm for the Evaluation of the Pt with Dyspnea Algorithm for the Evaluation of the Pt with Dyspnea

«Flowchart»

History and physical examination, plus:
Walking oximetry
Peak flow assessment

History and physical examination, plus:
Walking oximetry
Peak flow assessment

History and physical examination, plus:
Walking oximetry
Peak flow assessment

History and physical examination, plus:

Treat

Treat

Treat

End

End

End

EKG, electrocardiogram; DLCO, diffusing capacity for carbon monoxide; CBC, complete blood count.

EKG, electrocardiogram; DLCO, diffusing capacity for carbon monoxide; CBC, complete blood count.

EKG, electrocardiogram; DLCO, diffusing capacity for carbon monoxide; CBC, complete blood count.

Diagnosis obtained?

Diagnosis obtained?

Diagnosis obtained?

Yes

Yes

Yes

No

No

No

Further testing (“Phase 1”):
Chest x-ray
Spirometry
ECG
CBC, Basic metabolic panel

Further testing (“Phase 1”):
Chest x-ray
Spirometry
ECG
CBC, Basic metabolic panel

Further testing (“Phase 1”):
Chest x-ray
Spirometry
ECG
CBC, Basic metabolic panel

Further testing (“Phase 1”):

Further testing (“Phase 2”):
Chest CT (consider angiography for thromboembolic disease)
Lung volumes, DLCO, tests of neuromuscular function
Echocardiogram, Cardiac stress testing

Further testing (“Phase 2”):
Chest CT (consider angiography for thromboembolic disease)
Lung volumes, DLCO, tests of neuromuscular function
Echocardiogram, Cardiac stress testing

Further testing (“Phase 2”):
Chest CT (consider angiography for thromboembolic disease)
Lung volumes, DLCO, tests of neuromuscular function
Echocardiogram, Cardiac stress testing

Further testing (“Phase 2”):

Treat

Treat

Treat

Diagnosis obtained?

Diagnosis obtained?

Diagnosis obtained?

Yes

Yes

Yes

No

No

No

Treat

Treat

Treat

Further testing (“Phase 3”):
Consider cardiopulmonary exercise testing (and subspecialty referral)

Further testing (“Phase 3”):
Consider cardiopulmonary exercise testing (and subspecialty referral)

Further testing (“Phase 3”):
Consider cardiopulmonary exercise testing (and subspecialty referral)

Further testing (“Phase 3”):

Diagnosis obtained?

Diagnosis obtained?

Diagnosis obtained?

Yes

Yes

Yes

No

No

No