50 male

1

• 50 male
• PC- breathless 1 hour
• Cardiac catheter that day. Stent RCA
• PMH
• angina 2 weeks
• asthma 40 years. Inhaled seretide occas.
  Ventolin 3x daily
• hypertension 2y. ACEI
• FH
• 2 Kids have asthma
• Father died 48yo. AMI.

1. What are the causes that go through your
mind?
b. Gasping too SOB to speak Wheeze , but soft
breath sounds Cyanosed Pulsus paradoxus
a. Wheezing Hoarse Itchy skin BP 95/60
c. Gasping Tingling around lips No wheeze
2
JOURNEY DOWN INTO THE LUNGS
3
1. Anaphylaxis stridor, pruritus, medialert
2. Asthma COPD- wheeze
3. Pneumonia fever, localized signs
4. Pul. oedema crackles, S3, JVP
5. Pul. embolism unexplained dyspnoea
6. Pneumothorax dont rely on altered b/sounds.
Tracheal displacement.
7. Hyperventilation tingling lips/fingers

• Others
• Foreign body inhalation
• metabolic eg. kussmauls

4

• 50 male
• PC- breathless 1 hour
• Cardiac catheter that day. Stent RCA
• PMH
• angina 2 weeks
• asthma 40 years. Inhaled seretide occas.
  Ventolin 3x daily
• hypertension 2y. ACEI
• FH
• 2 Kids have asthma
• Father died 48yo. AMI.

b. Gasping too SOB to speak Wheeze , but soft
breath sounds Cyanosed Pulsus paradoxus
a. Wheezing Hoarse Itchy skin BP 95/60
c. Gasping Tingling around lips No wheeze
ANXIETY HYPERVENTILATION
ANAPHYLAXIS
SEVERE ASTHMA
5
Oxygen
1. Anaphylaxis adrenaline
2. Asthma COPD- salbutamol nebs (or IV )
steroids
3. Pneumonia antibiotics
4. Pul. oedema IV frusemide
5. Pul. embolism heparin
6. Pneumothorax remove air
7. Hyperventilation hold breath/reassurance/pape
r bag