Clinical investigations from the RACP

Investigating dyspnoea on exertion

Belinda R Miller, Daniel Garner
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Dyspnoea is a common symptom of many cardiac and respiratory conditions. Worsening dyspnoea on exertion is often present in the early stages of a disease and should always be thoroughly investigated.

Key Points

  • Dyspnoea is a common complaint, most frequently caused by respiratory or cardiac disease.
  • Multifactorial conditions are frequent; consider the presence of aggravating factors such as obesity, deconditioning, anaemia and anxiety.
  • Underlying diseases may be serious and irreversible.
  • The physiology of dyspnoea is complex, but its consideration often helps to clarify the cause of symptoms.
  • A careful history and examination in combination with simple investigations will often lead to a diagnosis.
  • Referral for specialist review and complex testing is needed in those in whom the cause is unclear.
  • The treatment of dyspnoea is often limited to management of its underlying cause, making accurate diagnosis the key to improving patient outcomes.