Dyspnea

Pulmonary

Common Etiologies

• Obstructive lung disease

  • Asthma including classification and exacerbation

  • Chronic Obstructive Pulmonary Disorder (COPD)

  • Obesity hypoventilation syndrome

• Pneumonia including

  • Community acquired pneumonia in the outpatient and inpatient settings

  • Hospital acquired pneumonia

• Pulmonary embolism

• Pulmonary arterial hypertension

Additional Considerations

• Emergent/urgent

  • Acute respiratory distress syndrome including COVID-19, EVALI

  • Pneumothorax

  • Hemothorax

• Pleural effusion

• Interstitial lung disease

  • Infectious

    • Risk factors: Age > 60 years with h/o COPD, renal failure, and/or sepsis at presentation

    • Workup progression: Laboratory testing + CXR → chest CT → bronchoscopy with lavage → surgical biopsy (VATS)

  • Non-infectious

    • Pneumonia: Eosinophilic, hypersensitivity

    • Inflammatory/fibrotic: Interstitial pulmonary fibrosis, connective tissue disorders (e.g. scleroderma), systemic vasculitis

    • Exposure: Occupational, medications (e.g. nitrofurantoin or amiodarone), chemical, radiation (e.g. radiation pneumonitis)

CT Findings for Pulmonary Disease

• Organizing pneumonia: Consolidation, nodules, perilobular pattern

• Non-specific interstitial pneumonia: Traction bronchiectasis, reticulation, ground glass

• Hypersensitivity pneumonitis: Traction bronchiectasis, honeycombing, centrilobular nodules, air trapping

• Idiopathic pulmonary fibrosis: Traction bronchiectasis, honeycombing, reticulation

• Sarcoid: Nodes, perilymphatic nodules

Cardiac

• Emergent: Acute coronary syndrome

• Heart failure with reduced or preserved ejection fraction

• Cardiomyopathy

  • Dilated cardiomyopathy

  • Hypertrophic cardiomyopathy

Other

• Anxiety/Panic disorder

• Metabolic acidosis

• Neuromuscular