Pneumologie
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The Berlin Questionnaire is an explorative tool of 13 questions designed to identify patients with obstructive sleep apnea. The questions are targeted toward key symptoms of snoring, apneas, daytime sleepiness, hypertension and overweight. ⋯ The Berlin Questionnaire is a poor predictor of obstructive sleep apnea in a random group of patients undergoing pulmonary rehabilitation.
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Patients often report of dyspnea during exertion which should be further analysed as a hint of heart or lung disease. When case history, chest X-ray, ECG, spirometry, and methacholine test do not explain the complaints, a cardiopulmonary exercise test is recommended. Parameters of spiroergometry can often elucidate cardiocirculatory or pulmonary causes. ⋯ In pulmonary triggered dyspnea the following pattern can be found: reduced maximal oxygen consumption, increased heart rate reserve, reduced breathing reserve. With the exercise tidal flow volume loop plotted within the maximal flow volume loop a more thorough interpretation is possible. In a case presentation, the decision-making process using the 9-panel display of Wasserman is demonstrated.