Clinical Management of Dyspnea (CAT Devant Une Dyspnée)

Vocabulary flashcards covering the definition, severity criteria, immediate management, clinical evaluation, and differential diagnosis of acute and chronic dyspnea based on clinical presentation and lung auscultation.

Dyspnea

A symptom defined as respiratory difficulty or discomfort in breathing.

Acute Dyspnea (Dyspnée aiguë)

Dyspnea presenting with a total duration of less than one week ($< 1\text{ week}$).

Chronic Dyspnea (Dyspnée chronique)

Dyspnea that has persisted for longer than one week ($> 1\text{ week}$).

Signs of Acute Respiratory Failure (Signes d'insuffisance respiratoire aiguë)

Severity criteria in dyspnea that include a respiratory rate $RR > 30/\text{min}$, cyanosis, sweating, signs of struggle, and suprasternal or intercostal retractions.

Hemodynamic Severity Signs (Signe de retentissement hémodynamique)

Cardiovascular signs of severity in a dyspneic patient comprising tachycardia ($> 120/\text{min}$), signs of shock, and circulatory collapse.

Neuro-psychiatric Severity Signs (Signe de retentissement neuro-psychique)

Neurological manifestations of severity including agitation, altered consciousness, and progression to coma.

Emergency First-Line Actions (Gestes urgents)

Immediate stabilizing measures comprising airway clearance, nasal $O_2$, semi-seated positioning, peripheral venous line with fluid infusion, and prompt transfer to an intensive care resuscitation unit.

Signs of Respiratory Exhaustion (Signes d'épuisement respiratoire)

Critical indications for immediate endotracheal intubation and mechanical ventilation, specifically bradypnea, paradoxical respiratory pauses, and major bronchial obstruction.

Laryngeal Dyspnea / Inspiratory Bradypnea (Dyspnée laryngée)

Noisy inspiratory dyspnea with retractions caused by Quincke's edema, acute epiglottitis, laryngeal cancer, compressive tracheal tumors, or foreign body aspiration.

Acute Pulmonary Edema (OAP)

A severe acute cardiac condition manifesting with orthopnea, crepitant crackles, frothy pinkish sputum, signs of heart failure, and chest radiography revealing diffuse alveolar opacities frequently accompanied by cardiomegaly.

Acute Asthma Attack (Crise d'asthme / AAG)

An episode occurring in patients with an asthma history, clinically presenting with expiratory wheezing (sibilants), expiratory bradypnea, and thoracic hyperinflation.

Spontaneous Pneumothorax

A condition characterized by sudden, sharp thoracic pain, variable dyspnea, and signs of pleural gas effusion, classically occurring in young, tall, slender individuals.

Pleural Effusion (Pleurésie)

A pleural condition presenting clinically with chest pain, variable dyspnea, dry cough, and physical signs of pleural fluid effusion confirmed by chest X-ray.

Pneumocystosis

An opportunistic pulmonary infection in HIV-positive individuals presenting with intense dyspnea, dry cough, low-grade fever, and a chest radiograph showing normal findings or an interstitial pattern.

Acute Dyspnea with Normal Lung Auscultation

Etiologies presenting without abnormal pulmonary adventitious sounds, including pulmonary embolism (EP), cardiac tamponade, acute anemia, chest wall abnormalities, and psychogenic dyspnea.

Acute Dyspnea with Crackles (Râles crépitants)

Auscultatory category associated with alveolar involvement, classically seen in acute pulmonary edema (OAP) and acute infectious pneumonia.

Acute Dyspnea with Auscultatory Asymmetry or Silence

Physical finding characterized by unilateral diminished breath sounds or auscultatory silence, pointing to pneumothorax, pleural effusion, or atelectasis.

Chronic Dyspnea Etiologies

Causes of prolonged respiratory difficulty classified into pulmonary conditions (chronic respiratory failure, BPCO), cardiac conditions (heart failure, ischemic or valvular heart disease, chronic obstructive pericarditis, left ventricular failure), and metabolic causes (chronic anemia).