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APPROACH TO PATIENT WITH ACUTE DYSPNEA IN THE EMERGENCY DEPARTMENT

Mohammed Saleh A Al Ibrahim, Hamzah Sadiq almumtin , Mohammed Mesfer Mohammed Almalki , Ahmed Abdulelah Al-Jishi , Abdulhamid Osama A Alama , Elaf Mohammed Taha Ibraheem Fakeih , Akram Saleh Kamal , Ahmed Mohammed Al Hammad , Mohammed Saleh M Alonazi , Ala Mohammed Hassan Al muttawa

Introduction: Acute dyspnea is considered one of the major causes for admission to the emergency department (ED) 1 There are several ways to evaluate patients with acute decompensated heart failure (ADHF) include but not limited to the history taking, performing physical examination, chest imaging, 12-lead electrocardiography (ECG), and measurement of brain natriuretic peptide (BNP) or N-terminal pro-BNP. The physical examination, is usually not accurate, starting “dual therapy” for ADHF and chronic obstructive pulmonary disease (COPD) is considered to be harmful.Aim of work: In this review, we will discuss the most recent evidence regarding the approach to dyspnea in the emergency department, presentation, and management.Methodology: We did a systematic search for approach to dyspnea in the emergency department using PubMed search engine (http://www.ncbi.nlm.nih.gov/) and Google Scholar search engine (https://scholar.google.com). Our search also looked for presentation, and management of diseases presents with dyspnea. All relevant studies were retrieved and discussed. We only included full articles.Conclusions: The diagnosis and management of patients presenting with acute dyspnea is one of the most important and challenging for clinicians in emergency department (ED). A right diagnosis is frequently delayed and difficult to confirm, explaining the need for fast diagnosis and a management plan. Acute dyspnea could present to the ED and it is imperative that emergency physicians be prepared to stabilize patients’ oxygenation and ventilation, which requires careful and efficient consideration of the differential diagnosis. Using many cues from the history and physical examination, practitioners may guide the work-up and treatment to identify a parenchymal, obstructive, circulatory, or compensatory cause of dyspnea. The early use of bedside testing, including ultrasonography, may limit unnecessary tests and save time in determining the best treatment course.

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