Dyspnea (shortness of breath) is the difficulty in breathing, the lack of air during breathing and patients describe it using many different expressions.    Many conditions can cause shortness of breath, and past medical history is very important with the   clinical   examination. Shortness of breath may have an acute start a few minutes or hours ago, or be chronic over weeks or even months.

The most common causes of acute – onset shortness of breath are:

  • Respiratory diseases such as asthma, pulmonary embolism, pneumonia, pneumothorax, pulmonary hemorrhage, pleural effusions.  These conditions may also be accompanied by other symptoms.
  •  Cardiological diseases, such as pulmonary edema or myocardial infarction.

Causes of chronic dyspnea

  • Heart failure
  • Chronic obstructive pulmonary disease
  • Pulmonary fibrosis and interstitial lung diseases
  • Anemia
  • Asthma
  • Obesity
  • Lack of exercise
  • Neuromuscular diseases

Test for the investigation of dyspnea

  • Spirometry or complete pulmonary function tests
  • Blood gases
  • Full blood count
  • Chest X-ray
  • CT Pulmonary Angiography
  • Cardiological Examination

Thoracic Pain is the pain which is localized in the chest and it is one of the most common symptoms for a  visit to outpatient clinics and emergency departments.

What are the causes?

There are many causes but it is important to know certain characteristics of pain such as the time of onset, duration, frequency, and the radiation. Also, if there are other symptoms such as hemoptysis, shortness of breath, fever, weight loss, the results of  the laboratory tests that will be needed.

Most common causes:

Respiratory system Pleurisy, Pulmonary embolism ,Pneumothorax, Lung Cancer,Pneumonia, Mesothelioma (malignancy of the pleural).

Cardiovascular system Acute myocardial infarction, Angina dissecting aorta  aneurysm, pericarditis.

Gastrointestinal system Gastroesophageal reflux, Spasm of the esophagus, Pancreatitis, peptic ulcer

Musculoskeletal system Pleurochondritis, Myalgia , Pancoast syndrome Rib injuries.

Because the causes are many, acute chest pain requires immediate diagnosis, since in many cases, such as myocardial infarction, pulmonary embolism, pneumothorax, and aortic aneurysm the patient’s life is threatened