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Breathlessness - Management
Basis for recommendation

  • Investigating chronic breathlessness of uncertain cause
    • Initial investigations. These tests are recommended by CKS based on their availability in primary care and their effectiveness for identifying an underlying cause.
    • Echocardiography. CKS recommends limiting the use of echocardiography/BNP to when initial investigations do not fully identify the cause of chronic breathlessness; to make the most effective use of these resources.
  • Investigating suspected acute asthma or an acute exacerbation of COPD
    • Investigations to confirm the diagnosis and distinguish COPD from asthma are based on expert opinion reported in the British guideline on the management of asthma: a national clinical guideline [SIGN and BTS, 2009] and Chronic obstructive pulmonary disease: management of chronic obstructive pulmonary disease in adults in primary and secondary care [NICE, 2010].
  • Investigating suspected bronchiectasis
    • Recommendations are based on expert opinion reported in the British thoracic society guideline for non-CF bronchiectasis [British Thoracic Society, 2010].
  • Investigating suspected bronchiectasis
    • Recommendations are based on expert opinion reported in the British thoracic society guideline for non-CF bronchiectasis [British Thoracic Society, 2010].
  • Investigating suspected pleural effusion
    • Chest radiography is recommended by experts, because of the lack of reliability of clinical findings to confirm the diagnosis [Gibson, 2010].
  • Investigating suspected diaphragmatic splinting secondary to ascites
    • CKS recommends arranging an abdominal ultrasound scan to confirm the presence of ascites and investigate the underlying cause.

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