TABLE 2-1 - Differential Diagnosis of Dyspnea

Categorical Cause of Dyspnea	Specific Cause of Dyspnea	Diagnostic Test(s) of Choice
Cardiac	Congestive heart failure/pulmonary edema Ischemia Valvular disease (AS, AI, MS. MR) Pericardial (tamponade, constriction) Restrictive heart disease (infiltrative or hypertrophic heart diseases)	CXR, echocardiogram, metabolic stress test; BNP ECG. Exercise stress test Echocardiogram Echocardiogram Echocardiogram
Pulmonary	COPD Asthma Pneumonia Pleural effusion Pulmonary embolism Pneumothorax Pulmonary fibrosis Pulmonary hypertension Airway obstruction	CXR, PFT s PFTs, methacholine challenge CXR CXR V/Q scan, spiral CT scan, PA angiogram CXR CXR, high resolution CT scan Echocardiogram, PA catheter CXR, PFTs, bronchoscopy
Other	Anemia Hyperthyroidism Diaphragmatic paralysis	Hematocrit TSH PFT s, CXR

CXR: chest x-ray; BNP: brain natriuretic peptide; ECG: electrocardiogram; AS/I: aortic stenosislinsufficiency; MS/R: mitral stenosis/regurgitation; COPD: chronic obstructive pulmonary disease; PFTs: pulmonary function tests;V/Q: ventilation- perfusion; CT: computed tomography; TSH: thyroid stimulating hormone.