breathlessness (dyspnea)

greenfylde
Mind Map by , created almost 6 years ago

FOCP- cardio Mind Map on breathlessness (dyspnea), created by greenfylde on 11/19/2013.

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greenfylde
Created by greenfylde almost 6 years ago
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breathlessness (dyspnea)
1 Anxiety
2 Asthma
3 COPD
4 Lung cancer (py or 2ndry)
5 Pneumonia
6 PE
7 Stridor
7.1 Upper airway obstruction (foreign body, anaphylaxis, epiglotttis, extrinsic compression)
8 Cardiac Failure
8.1 epidem: incidence up w/age, 50% dead 5y
8.2 causes: CAD (also IHD, cardiomyopathy, hypertens)
8.3 types
8.3.1 R sided
8.3.1.1 Cor pulmonale (R sided heart fail due to resp cause eg COPD)
8.3.1.2 peripheral edema
8.3.2 Lsided
8.3.2.1 pulmonary edema
8.3.3 Both = Congestive (CCF)
8.3.4 Chronic more common, Acute bad prog
8.4 pathphys: compensate -> overwhelmed, activate renin/angiotens/aldost -> periph vasoconstric + sodium retain
8.4.1 venous press up -> edema, outflow resist up so CO down, bad for contractility, chronic symp nervous system activation (down reg B receptors)
8.4.1.1 myocard remodelling, abnormal Ca ++ homeostasis, natriuritic peptides released b/c stress, ADH up
8.5 symps
8.5.1 exertional dyspnea (or if bad, resting), orthopnea, PND, fatigue
8.6 signs
8.6.1 cardiomegaly, S3 and S4, tachy, hypotens, bi-basal crackles, pleural effusion, ankle edema, ascites, tender hepatomegaly; with liver symps, can get jaundice later on
8.7 investigs:
8.7.1 bloods
8.7.1.1 FBC, LFT, U+E, tropoins (if acute), BNP, TFT
8.7.2 CXR
8.7.2.1 cardiomegaly, pulm congestion, fluid in fissures, Kerley B lines, pulm edema
8.7.3 ECG
8.7.3.1 ichemia, hypertension, or arrhythmai
8.7.4 Echo
8.7.4.1 chamber dimension, systolic + diastolic funct, regional wall motion abnorms, valvular heart disease, cardiomyopathies
8.7.5 Others: Nuclear cardiology, Cardiac MRI, Cardiac catheter, cardiac biopsy, cardiopulm exercise test, 24hr ECG)
8.8 Treatment
8.8.1 Lifestyle
8.8.2 Monitor
8.8.3 Drugs
8.8.3.1 diruetics (loop + thiazaide) for symps not surviv
8.8.3.2 ACE INHIBITORS
8.8.3.2.1 improve prog!!!!
8.8.3.3 B blockers
8.8.3.4 Aldost antags
8.8.3.4.1 spirinolactone + eplerenone: improve survival!
8.8.3.5 cardiac glycosides eg digox (for symp relief)
8.8.4 Nonpharm
8.8.4.1 Revasculariz
8.8.4.2 pacemaker
8.8.4.3 Heart transplant
9 Other: Infect (bronchitis, bronciectasis exac, anaphylaxis, pleural effusion, pneumothorax, fibrosis, tb obesity, chest wall injury, metabolic acidosis)
10 valvular disease
10.1 see valvular disease chart
11 Arrythmia
11.1 see notes
12 Cardiac tamponade
13 Acute coronary syndrome (incl MI, angina)
13.1 see 'chest pain' flow chart

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