CLINICAL DIAGNOSTIC MANUAL
Orthopnoea and paroxysmal nocturnal dyspnoea (PND) are respiratory symptoms indicating breathing difficulties associated with body positions and specific times of the day. Orthopnoea refers to difficulty breathing while lying down, causing the patient to sleep sitting up or semi-upright to alleviate symptoms.
Paroxysmal nocturnal dyspnoea, on the other hand, is the sudden onset of breathlessness that occurs at night, waking the patient with a sensation of suffocation that generally improves upon sitting or standing.
Pathology | Suspected Diagnosis | Confirmatory Diagnosis |
Pulmonary oedema | Severe dyspnoea, orthopnoea, productive cough with pink, frothy sputum | Chest X-ray, echocardiogram, elevated BNP or NT-proBNP |
COPD | Chronic dyspnoea, cough with sputum, history of smoking | Spirometry, chest X-ray |
Asthma | Episodes of wheezing, coughing, dyspnoea that worsen at night or when lying down | Spirometry, bronchoprovocation test, clinical history |
Cardiac arrhythmia | Palpitations, dizziness, syncope, paroxysmal nocturnal dyspnoea | Electrocardiogram (ECG), Holter monitoring, echocardiogram |
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