• Dominik Berliner, Nils Schneider, Tobias Welte, and Johann Bauersachs.
• Department of Cardiology and Angiology, Hannover Medical School; Institute for General Practice, Hannover Medical School; Department of Respiratory Medicine, Hannover Medical School.
• Dtsch Arztebl Int. 2016 Dec 9; 113 (49): 834-845.

BackgroundDyspnea is a common symptom affecting as many as 25% of patients seen in the ambulatory setting. It can arise from many different underlying conditions and is sometimes a manifestation of a life-threatening disease.MethodsThis review is based on pertinent articles retrieved by a selective search in PubMed, and on pertinent guidelines.ResultsThe term dyspnea refers to a wide variety of subjective perceptions, some of which can be influenced by the patient's emotional state. A distinction is drawn between dyspnea of acute onset and chronic dyspnea: the latter, by definition, has been present for more than four weeks. The history, physical examination, and observation of the patient's breathing pattern often lead to the correct diagnosis, yet, in 30-50% of cases, more diagnostic studies are needed, including biomarker measurements and other ancillary tests. The diagnosis can be more difficult to establish when more than one underlying disease is present simultaneously. The causes of dyspnea include cardiac and pulmonary disease (congestive heart failure, acute coronary syndrome; pneumonia, chronic obstructive pulmonary disease) and many other conditions (anemia, mental disorders).ConclusionThe many causes of dyspnea make it a diagnostic challenge. Its rapid evaluation and diagnosis are crucial for reducing mortality and the burden of disease.

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