Paediatrics: Common presentation: breathlessness

Common presentation: breathlessness

Being short of breath can be due to heart or lung disease. In lung disease, this sensation arises because of lack of oxygen, difficulty breathing due to airway obstruction, or abnormal lung mechanics. Infants may not be able to express their discomfort—in this instance you will need to be able to identify signs of respiratory distress. The causes include the following.

Differential diagnosis

Airway obstruction

·  Upper airway.

·  Lower airway.

Abnormal lung mechanics

·  Restrictive lung disease: e.g. chest wall (obesity), chest deformity, kyphoscoliosis.

·  Parenchymal lung disease: e.g. pneumonia, pulmonary hypertension.

·  Muscle weakness: e.g. Duchenne muscular dystrophy, diaphragmatic paralysis.

Hypoxia

·  Ventilation perfusion mismatch: e.g. lung disease, pneumonia, pneumothorax, pulmonary embolism.

·  Heart disease: e.g. cyanotic congenital heart disease, pericarditis and myocarditis.

Emergency treatment and care Discussed earily.