Patients with dyspnea in the practice of a general practitioner
https://doi.org/10.18093/0869-0189-2020-30-6-842-846
Abstract
Shortness of breath, a subjective feeling of lack of air, is one of the most common complaints that patients present to a general practitoner or any other primary care doctor. The range of pathological conditions and diseases accompanied by shortness of breath is diverse and often poses a difficult diagnostic task for the doctor. These conditions may include such life-threatening pathologies as myocardial infarction or pulmonary embolism on the one hand, and conditions that are relatively “harmless” from a prognostic point of view, such as hyperventilation syndrome and detraining, on the other. The more experienced a doctor is, the wider this range will be. However, certain stereotypes are usually triggered in the management of such patients in the routine practice and the pathology that the general practitioner faces most often, prevails. Our clinical example clearly shows how the present cardiovascular condition (hypertension) masks other signs, and the shortness of breath is easily explained by a complication of hypertension - heart failure. Nevertheless, this case turned out to be more complicated. This clinical example shows the main problems of differential diagnosis of shortness of breath in the practice of a general practitioner or a family doctor. This case emphasizes that a multidisciplinary approach should be applied to the diagnosis and treatment of patients with dyspnea.
About the Authors
N. V. Gordeeva
V.F. Voyno-Yasenetskiy Krasnoyarsk State Medical University, Healthcare Ministry of Russia; Krasnoyarsk State Territorial Clinical Hospital
Russian Federation
Competing Interests: not
Russian Federation
Natalya V. Gordeeva - Candidate of Medicine, Associate Professor, Department of Internal Medicine No.2 and Postgraduate Physician Training Course, V.F.Voyno-Yasenetskiy Krasnoyarsk SMU, Healthcare Ministry of Russia; pulmonologist of the pulmonary-allergy center, Krasnoyarsk STlCH.
Ul. Partizana Zheleznyaka 1, Krasnoyarsk, 660022; tel.: (913) 199-06-53
Competing Interests: not
I. V. Demko
V.F. Voyno-Yasenetskiy Krasnoyarsk State Medical University, Healthcare Ministry of Russia; Krasnoyarsk State Territorial Clinical Hospital
Russian Federation
Competing Interests: not
Russian Federation
Irina V. Demko - Doctor of Medicine, Professor, Head of Department of Internal Medicine No.2 and Postgraduate Physician Training Course, V.F.Voyno-Yasenetskiy Krasnoyarsk SMU, Healthcare Ministry of Russia; Head of Pulmonology and Allergology Center, Krasnoyarsk STlCH.
Ul. Partizana Zheleznyaka 1, Krasnoyarsk, 660022; tel.: (913) 507-84-08
Competing Interests: not
M. G. Mamaeva
V.F. Voyno-Yasenetskiy Krasnoyarsk State Medical University, Healthcare Ministry of Russia; Krasnoyarsk State Territorial Clinical Hospital
Russian Federation
Competing Interests: not
Russian Federation
Marina G. Mamaeva - Candidate of Medicine, Assistant, Department of Internal Medicine No.2 and Postgraduate Physician Training Course, V.F.Voyno-Yasenetskiy Krasnoyarsk SMU, Healthcare Ministry of Russia; pulmonologist, Department of pulmonology, Krasnoyarsk STlCH.
Ul. Partizana Zheleznyaka 1, Krasnoyarsk, 660022; tel.: (913) 836-18-30
Competing Interests: not
S. V. Zelenyy
Krasnoyarsk State Territorial Clinical Hospital
Russian Federation
Competing Interests: not
Russian Federation
Sergey V. Zelenyy - Head of Pulmonology Department, Krasnoyarsk State Territorial Clinical Hospital
Ul. Partizana Zheleznyaka 3A, Krasnoyarsk, 660022; tel.: (913) 831-98-54
Competing Interests: not
A. Yu. Kraposhina
V.F. Voyno-Yasenetskiy Krasnoyarsk State Medical University, Healthcare Ministry of Russia; Krasnoyarsk State Territorial Clinical Hospital
Russian Federation
Competing Interests: not
Russian Federation
Angelina Yu. Kraposhina - Candidate of Medicine, Associate Professor, Department of Internal Medicine No.2 and Postgraduate Physician Training Course, V.F.Voyno-Yasenetskiy Krasnoyarsk SMU, Healthcare Ministry of Russia, pulmonologist, Pulmonary-allergy center, Krasnoyarsk STlCH.
Ul. Partizana Zheleznyaka 1, Krasnoyarsk, 660022; tel.: (902) 990-37-67
Competing Interests: not
I. A. Solov 'eva
V.F. Voyno-Yasenetskiy Krasnoyarsk State Medical University, Healthcare Ministry of Russia; Krasnoyarsk State Territorial Clinical Hospital
Russian Federation
Competing Interests: not
Russian Federation
Irina A. Solov'eva - Candidate of Medicine, Assistant Lecturer, Department of Internal Medicine No.2 and Postgraduate Physician Training Course, V.F.Voyno-Yasenetskiy Krasnoyarsk SMU, Healthcare Ministry of Russia.
Ul. Partizana Zheleznyaka 1, Krasnoyarsk, 660022; tel.: (913) 835-26-43
Competing Interests: not
V. A. Mosina
V.F. Voyno-Yasenetskiy Krasnoyarsk State Medical University, Healthcare Ministry of Russia; Krasnoyarsk State Territorial Clinical Hospital
Russian Federation
Competing Interests: not
Russian Federation
3А; тел.: (913) 558-98-59; e-mail: carolina@kraslan.ru
Valentina A. Mosina - Candidate of Medicine, Associate Professor, Department of Internal Medicine No.2 and Postgraduate Physician Training Course, V.F.Voyno-Yasenetskiy Krasnoyarsk SMU, Healthcare Ministry of Russia, cardiologist, Department of cardiology, Krasnoyarsk STlCH.
Ul. Partizana Zheleznyaka 1, Krasnoyarsk, 660022; tel.: (913) 558-98-59
Competing Interests: not
Е. A. Verbitskaya
V.F. Voyno-Yasenetskiy Krasnoyarsk State Medical University, Healthcare Ministry of Russia
Russian Federation
Competing Interests: not
Russian Federation
ElenaA. Verbitskaya - VI year student.
Ul. Partizana Zheleznyaka 1, Krasnoyarsk, 660022; tel.: (923) 577-52-89
Competing Interests: not
Yu. A. Tolstokorova
Krasnoyarsk State Territorial Clinical Hospital
Russian Federation
Competing Interests: not
Russian Federation
Yuliyа A. Tolstokorova - VI year student.
Ul. Partizana Zheleznyaka 1, Krasnoyarsk, 660022; tel.: (909) 524-38-30
Competing Interests: not
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Review
For citations:
Gordeeva N.V., Demko I.V., Mamaeva M.G., Zelenyy S.V., Kraposhina A.Yu., Solov 'eva I.A., Mosina V.A., Verbitskaya Е.A., Tolstokorova Yu.A. Patients with dyspnea in the practice of a general practitioner. PULMONOLOGIYA. 2020;30(6):842-846. (In Russ.) https://doi.org/10.18093/0869-0189-2020-30-6-842-846
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