Last updated: April 6, 2026, 6:50 PM Pacific Time (PDT)
Symptom-first framework for dyspnea, tachypnea, hypoxemia, or increased work of breathing. Stabilize first, then separate obstructive, parenchymal, vascular, cardiac, metabolic, and upper-airway causes.
Activate the assistant to re-rank likely dyspnea causes from partial clinical data.
Presentation
Pulmonary clues
Cardiovascular clues
High-risk context
Likely diagnoses from entered data
Recommended next labs, imaging, and diagnostics
Flowchart
First Pass
Shortness of breath is a syndrome, not a final diagnosis
Clarify severity, work of breathing, hypoxemia, and tempo. Immediate threats include airway compromise, severe asthma or COPD, pulmonary edema, PE, pneumothorax, and sepsis.
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Immediate stabilization
Treat airway, oxygenation, and hemodynamic threats first
Hypoxemia, impending fatigue, shock, and rapidly worsening work of breathing should move ahead of diagnostic refinement.
Pulmonary / parenchymal
Wheeze
Asthma or COPD exacerbation
Wheezing, obstructive history, and hyperinflation clues push toward obstructive physiology.
Fever + cough
Pneumonia or other lower respiratory infection
Fever, productive cough, focal findings, or infiltrates support infection.
Cardiac
Orthopnea / edema
Heart failure or pulmonary edema
Orthopnea, edema, crackles, or cardiac history pull toward congestion and decompensation.
Chest pain
ACS, arrhythmia, or ischemic dyspnea
Not all dyspnea is primarily pulmonary.
Vascular / pleural
Pleuritic + tachycardic
Pulmonary embolism
Think PE when dyspnea is acute, unexplained, pleuritic, or paired with DVT risk.
Sudden unilateral
Pneumothorax or pleural catastrophe
Sudden onset, unilateral findings, or hemodynamic compromise should make you pause here.
Other important buckets
Systemic
Metabolic acidosis, anemia, or sepsis-related dyspnea
Not all dyspnea starts in the lungs or heart.
Upper airway
Upper-airway obstruction
Stridor or voice change should redirect attention upward quickly.