SOB

H & P:

Acute MI

Chest pressure, radiates, dyspnea, nausea, diaphoresis, CVD risk factors

GEN: Pallor, diaphoresis / CVS: Murmur, peripheral edema

Anaphylaxis

Known allergen, dyspnea, wheeze, chest tightness, cough, rash, pruritis, NVD

GEN: ↓BP, resp distress, urticaria, erythema / RESP: Wheeze, stridor

Aortic dissection

Tearing pain, radiates, dyspnea, paresthesia, CVD risk factors

CVS: ↑BP, asymmetric BP, murmur / PVS: Limb ischemia, asymmetric pulses

Asthma, COPD

Known irritant, dyspnea, wheeze, chest tightness, cough, sputum

GEN: Respiratory distress, cyanosis / RESP: Wheeze, silent chest

Heart failure

Dyspnea, orthopnea, cough, weight gain, CVD risk factors

CVS: ↑JVP, S3/S4, peripheral edema / RESP: Wheeze, crackles

Pneumonia

Dyspnea, fever, cough, sputum, NVD, Hx travel, Hx sick contacts

GEN: Fever / RESP: Wheeze, ↓percuss, ↓A/E, ↑fremitus

Pneumothorax

Dyspnea, sharp pleuritic pain, Hx trauma, Hx instrumentation

GEN: Tachypnea, subcutaneous emphysema / RESP: ↓A/E, ↑percussion

Pulmonary embolism

SOB, pleuritic pain, hemoptysis, Sx, immobility, smoker, BCP, Ca, Hx DVT/PE

GEN: Tachypnea, tachycardia / PVS: Leg edema, erythema, heat, tenderness

Tamponade

Sharp pleuritic pain, dyspnea, orthopnea, Hx trauma

GEN: ↓BP, tachycardia, pallor, diaphoresis / CVS: ↑JVP, ↓S1/S2, pulsus paradoxus

Investigation:

CBC, Lytes, Cr, LFT, Lipase, BhCG, Trop, ECG, CXR, U/S, CT