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Acute dyspnea

Dyspnée aiguë
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I- Introduction:

II- Definitions:

III- Pathophysiology:

IV- Diagnostic approach:

1- Interrogation:

Table I. – Clinical signs of severity in the presence of dyspnea.

HTA, coronary artery disease (angor, IDM, bypass)
Diffuse Atherosclerosis (stroke, Arteritis Ml)
Risk factors for MTE (ATCD, surgery, bed rest, neoplasia)

2- Physical review:

A- Pleuropulmonary review:

Dyspnea: etiological orientation according to auscultation

B- Cardiovascular review:

C- Clinical review:

3- Additional reviews:

A- Thorax X-ray:

B- Arterial gas:

C- Electrocardiogram:

D- Echocardiography:

E- Other reviews:

V- Etiological Diagnosis:

1- Acute asthma:

Etiological treatment

2-mimetic aerosols: Salbutamol-terbutaline (Ventoline-Bricanyl)

Anticholinergics: Atrovent – Ipratropium Bromide Nebulization 5mg/0.5mg20min, 3 times/h then every 4h Corticosteroids: Solumédrol 2mg/kg, Hydrocortisone 15 mg/kg

2- Bronchopneumonia:


Probabilistic early antibiotic therapy

3- Acute DEcompensations of COPD:


4- OAP:

OAP Lesional



Cardiogenic OAP

3 phases



PA surveillance:

Risk factor

5- Pulmonary embolism:



6- Pneumothorax:

7- Tuberculosis:

8- Lung cancer:

9- Metabolic:

10- Neuromuscular:

11- Intra bronchial foreign body:

12- Laryngé edema:

13- Other diagnoses:

14- CO poisoning:


Initial signs: headache, nausea, vomiting, impaired consciousness, memory, dizziness, fatigue

Signs of gravity: deep coma, hypertonic calm, trismus, convulsions

Vegetative signs: hyperthermia, sweating and pink “cochineal” gingling of teguments

CO support

VI- Treatment:

Symptomatic treatment:

Ventilatory assistance:

VII- Conclusion:

Dr. FOUGHALI Course – Constantine Faculty

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