Differentiation between pulmonary and cardiac causes of Dyspnoea

Dyspnoea due to pulmonary aetiology has the following features

• Cough with expectoration precedes dyspnoea.
• Wheeze or stridor.
• Pleuritic chest pain.
• Pyrexia.
• Seasonal variation.
• Weight loss.
• Cyanosis (++ or +++).
• Progression over many years.
• Response to oxygen, bronchodilalors.
• Absence of obvious cardiac disease.

Dyspnoea due to cardiac aetiology has the following features

• PND and orthopnoea.
• Dyspnoea precedes cough with expectoration.
• Associated angina, syncope, palpitation: hypertension.
• Rapid progression of symptoms.
• Little or no cyanosis {+).
• Response to diuretics and digoxin.
• Physical signs of cardiac disease.