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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.).


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