A woman with breathlessness: a practical approach to diagnosis and management

Alan Kaplan, Kevin Gruffydd-Jones, Frederik van Gemert, Bruce J Kirenga, Andrew R L Medford

Research output: Contribution to journalArticle (Academic Journal)peer-review

2 Citations (Scopus)


Worsening breathless in a patient with severe chronic obstructive pulmonary disease (COPD) is a common diagnostic and management challenge in primary care. A systematic approach to history-taking and examination combined with targeted investigation of pulmonary, cardiovascular, thromboembolic and systemic causes is essential if co-morbidities are to be identified and managed. Distinguishing between heart failure and COPD is a particular challenge as symptoms and signs overlap. In low and middle income countries additional priorities are the detection of infections such as tuberculosis and human immunodeficiency virus (HIV). Clinicians need to be alert to the possibility of atypical presentations (such as pain-free variants of angina) and less common conditions (including chronic thromboembolic pulmonary hypertension) in order not to overlook important potentially treatable conditions.

Original languageEnglish
Pages (from-to)468-76
Number of pages9
JournalPrimary care respiratory journal : journal of the General Practice Airways Group
Issue number4
Publication statusPublished - Dec 2013


  • Albuterol
  • Bronchodilator Agents
  • Diagnosis, Differential
  • Disease Progression
  • Dyspnea
  • Female
  • Heart Failure
  • Humans
  • Lung Neoplasms
  • Middle Aged
  • Pneumonia
  • Pulmonary Disease, Chronic Obstructive


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