Physical Signs of Dyspnoea
The relevant physical signs, and their significance, in patients with dyspnoea are:
Respiratory
| Sign | Significance |
| Tachyopnea | Indicates respiratory distress (non-specific) Associated with majority of causes of dyspnoea |
| Bradypnoea | Very worrying sign indicating potential respiratory arrest |
| irregular respiratory pattern | Intracranial event |
| Stridor | Upper airways obstruction (e.g. anaphylaxis) |
| Asymmetrical chest wall movement | Usually associated with injury / local tenderness Pneumothorax (+/- tension), fractured ribs, flail segment |
| Subcutaneous emphysema | Pneumothorax, rib fractures |
| Unilateral decreased air entry | Pneumothorax (+/- tension), Pleural effusion Collapse/Consolidation/Contusion |
| Crepitations | Inspiratory, fine: pulmonary oedema / fibrosis Expiratory, coarse, may be focal: pneumonia |
| Wheeze | Inspiratory/Monophonic: Focal bronchial obstruction. Expiratory/Polyphonic: COPD/Asthma |
| Bronchial breath sounds | Consolidation – pneumonia |
| Friction rub | Pleurisy, pulmonary embolus |
Cardiovascular
| Sign | Significance |
| Tachycardia | Indicates respiratory distress (non-specific) |
| Hypotension | Serious underlying pathology including PE, tension pneumothorax, sepsis, cardiac tamponade |
| Elevated jugular venous pressure (JVP) | Tension pneumothorax, cardiac tamponade, PE, pulmonary hypertension, congestive cardiac failure (CCF) |
| Cardiac murmur | Valvular abnormality |
| Added heart sounds | S3/S4 gallop rhythm in cardiac failure Massive PE with right ventricular failure |
General
| Sign | Significance |
| Pyrexia | Infection pneumonia |
| Weight loss | Malignancy |
| Clubbing | Chronic respiratory conditions, congenital heart disease |
| Pallor | Anaemia |
| Cyanosis | Severe respiratory compromise, cyanotic heart disease |
| Muscle wasting | Neuromuscular disease |
| Peripheral oedema | Congestive cardiac failure |
| Calf tenderness | Pulmonary embolism (PE) |
| Hand tremor/flap | CO2 retention |