Authors: Jason M Kendall / Editor: Tajek B Hassan / Reviewer: Emma Everett, Peter Lynas, Rafeeq Ahmed Sulaiman / Codes: A2 / Published: 28/12/2020 / Reviewed: 28/03/2024

This session is about the assessment and management of patients presenting with breathlessness to the emergency department (ED).

After completing this session you will be able to:

  • Recognise the common causes of breathlessness
  • Describe the pathophysiology of breathlessness
  • Describe the initial approach to a breathless patient in the emergency department
  • Elicit an appropriate history in patients presenting with breathlessness
  • Demonstrate the discriminating physical signs associated with different causes of breathlessness
  • Plan and interpret appropriate investigations in patients with breathlessness in order to achieve a diagnosis.


  1. Manning HL, Schwartzstein RM. Pathophysiology of dyspnea. N Engl J Med. 1995 Dec 7;333(23):1547-53.
  2. Lane R, Cockcroft A, Adams L, Guz A. Arterial oxygen saturation and breathlessness in patients with chronic obstructive airways disease. Clin Sci (Lond). 1987 Jun;72(6):693-8.
  3. Binks AP, Vovk A, Ferrigno M, Banzett RB. The air hunger response of four elite breath-hold divers. Respir Physiol Neurobiol. 2007 Nov 15;159(2):171-7.
  4. Homma I, Obata T, Sibuya M, et al. Gate mechanism in breathlessness caused by chest wall vibration in humans. J Appl Physiol 1984;56:8-11.
  5. Michelson E, Hollrah S. Evaluation of the patient with shortness of breath: an evidence based approach. Emerg Med Clin North Am. 1999 Feb;17(1):221-37, x.
  6. Benacerraf BR, McLoud TC, et al. An assessment of the contribution of chest radiography in outpatients with acute chest complaints: a prospective study. Radiology. 1981 Feb;138(2):293-9.
  7. Wells PS, Ginsberg JS, Anderson DR, et al. Use of a clinical model for safe management of patients with suspected pulmonary embolism. Ann Intern Med. 1998 Dec 15;129(12):997-1005.
  8. British Thoracic Society Standards of Care Committee Pulmonary Embolism Guideline Development Group. British Thoracic Society guidelines for the management of suspected acute pulmonary embolism. Thorax. 2003 Jun;58(6):470-83.
  9. O’Driscoll BR, Howard LS, Earis J on behalf of the British Thoracic Society Emergency Oxygen Guideline Group, et al. BTS guideline for oxygen use in adults in healthcare and emergency settings. Thorax 2017;72:ii1-ii90.
  10. National Institute for Health and Care Excellence (NICE). Breathlessness. NICE CKS, 2022.
  11. Assessment of dyspnoea. BMJ Best Practice, 2024.

Leave a Reply