Acute respiratory distress, sudden onset in second

CLINICAL DIAGNOSTIC MANUAL

Acute respiratory distress that begins suddenly, within seconds, is a warning sign that may indicate a critical airway obstruction or an acute cardiovascular or pulmonary event. This type of respiratory distress requires immediate intervention due to the potential for life-threatening conditions, such as pulmonary embolism, pneumothorax, or anaphylaxis. Quickly identifying the underlying cause is key to applying appropriate treatment and preventing clinical deterioration.

Pathology	Symptoms and Clinical Signs	Suspected Diagnosis	Confirmed Diagnosis
Pulmonary embolism	Sudden respiratory distress, pleuritic chest pain, tachycardia, possible haemoptysis.	History of immobilisation, deep vein thrombosis, or risk factors for PE.	CT pulmonary angiogram showing obstruction in pulmonary arteries. Elevated D-dimer.
Pneumothorax	Sudden dyspnoea, unilateral chest pain, reduced breath sounds, hypotension in cases of tension pneumothorax.	Acute chest pain with diminished breath sounds on the affected side.	Chest X-ray showing lung collapse or mediastinal shift in tension pneumothorax.
Anaphylaxis	Rapid dyspnoea, wheezing, facial swelling, urticaria, pruritus, hypotension.	History of exposure to an allergen and rapid onset of symptoms.	Clinical diagnosis. Immediate treatment with adrenaline required.
Foreign body inhalation	Sudden dyspnoea, intense coughing, stridor, possible cyanosis, feeling of choking.	History of ingestion of an object or food, abrupt dyspnoea, and signs of airway obstruction.	Bronchoscopy or neck X-ray showing the foreign body in the airway.
Cardiac arrhythmia	Acute dyspnoea with palpitations, dizziness, syncope, or chest pain.	History of heart disease, acute dyspnoea with cardiac and haemodynamic symptoms.	Electrocardiogram showing arrhythmia (ventricular tachycardia, ventricular fibrillation, etc.).