MANUAL OF CLINICAL DIAGNOSIS
Decreased breath sounds refer to a reduction in the intensity of respiratory noises heard through the chest. This finding can indicate a variety of pathological conditions that affect lung ventilation or the transmission of sound through the lung tissue and pleura. Identifying the underlying cause is crucial, as some of these conditions can be potentially serious and require immediate medical intervention.
Pathology | Clinical Symptoms and Signs | Suspected Diagnosis | Confirmatory Diagnosis |
Decreased Respiratory Effort | Bradypnoea, hypoventilation, drowsiness, hypercapnia | Medical history, physical examination, decreased breath sounds | Arterial blood gas analysis, chest X-ray |
Endobronchial Obstruction | Cough, wheezing, dyspnoea, atelectasis | Medical history, physical examination, decreased breath sounds in the affected area | Bronchoscopy, chest X-ray, chest computed tomography (CT) |
Severe Asthma | Dyspnoea, wheezing, use of accessory muscles, cyanosis | History of asthma, physical examination, decreased breath sounds | Spirometry, arterial blood gas analysis |
Anaphylaxis | Sudden dyspnoea, wheezing, oedema, urticaria, hypotension | History of allergen exposure, physical examination, decreased breath sounds | Allergy testing, blood tests (tryptase) |
Emphysema | Progressive dyspnoea, chronic cough, decreased breath sounds, barrel chest | Smoking history, physical examination, decreased breath sounds | Chest X-ray, chest CT, spirometry |
Obesity | Exertional dyspnoea, snoring, hypoventilation, decreased breath sounds | Medical history, physical examination, decreased breath sounds | Body mass index (BMI), polysomnography |
Pneumothorax | Sudden chest pain, dyspnoea, decreased or absent breath sounds on the affected side | Medical history, physical examination, decreased breath sounds on the affected side | Chest X-ray, chest CT |
Pleural Effusion | Dyspnoea, pleuritic chest pain, dull percussion, decreased breath sounds | Medical history, physical examination, decreased breath sounds | Chest X-ray, thoracic ultrasound, chest CT |
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