SHORTNESS OF BREATH

Not always easy to diagnose, particularly if patient presents with chronic rather than acute symptoms; cause may be cardiac, respiratory or other. Difficulty breathing is called dyspnoea.

• Respiratory causes include: asthma, emphysema, COPD, chest infection
• Cardiac causes include: congestive heart failure
• Other causes include: anaemia, pulmonary embolus, being overweight, being in great pain, anxiety and other emotional problems.

Assessment

Two scales used to assess breathlessness are:

• Medical Research Council (MRC) Dyspnoea Scale, used in patients with COPD, grading 1-5

• New York Heart Association (NYHA) Functional Classification of Breathlessness, used in patients with heart failure, grading I-IV.

A modified version of the MRC Dyspnoea Scale (mMRC) is recommended in the GOLD COPD guidelines, and is available as an online calculator at https://www.mdcalc.com/mmrc-modified-medical-research-council-dyspnea-scale