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Cardio Pulm Diff Dx

Differential Diagnoses in Cardiovascular and Pulmonary Systems

QuestionAnswer
Asthma Wheezing cough Dry or productive mucoid sputum with plugs
Bronchitis Chronic inflamm with cough and sputum production Wheezing or rhonchi breath sounds Productive mucoid or purulent sputum with infection May have fever
Cystic Fibrosis May be obstructive, restrictive, or mixed Rales, wheezing, and/or decreased breath sounds Inability to gain weight Productive of large amounts of mucoid, mucopurulent, or purulent sputum. May have hemotysis, cyanosis, clubbing
Emphysema Permanent abnormal enlargement and destruction of air spaces. Barreled chest Use of accessory ventilation muscles Decreased breath sounds with or without wheezing Dyspnea
Pneumothorax Decreased or absent breath sounds Dry cough May have local or referred pain Tracheal deviation away from affected side Hyperresonant and tympanic percussion sound.
Tuberculosis (TB) Slight nonproductive cough Hemoptysis Low grade fever Chest wall pain Possible chest x-ray changes
Pulmonary Edema Can be due to LV failure, aortic valvular disease, mitral valvular disease, narcotic overdose. Dyspnea on exertion or paroxysmal nocturnal dyspnea Fatigue Pink frothy sputum Positive chest x-ray Crackles
Pulmonary Emboli Without infarction = tachypnea, anxiety, restlessness, rales (crackles), wheezing, decreased breath sounds With infaction = chest pain, hemoptysis, pleural friction rub, fever, positive chest x-ray
Pleural Effusion Exessive fluid netween visceral and parietal pleura Decreased breath sounds over effusion Bronchial breath sounds around perimeter Mediastinal shift away from large effusion Breathlessness, with large effusions Chest x-ray shows fluid
Atelectasis Collapsed or airless alveolar unit Decreased breath sounds Dyspnea Tachycardia Increased temperature Chest x-ray shows platelike streaks
Angina Pectoris Pain in chest, jaw, or L shoulder Other symptoms = indigestion, dyspnea, dizziness, syncope, and anxiety.
Cor Pulmonale Failure or hypertrophy of RV resulting from disorders of lungs, pulmonary vessels, or chest wall. Usually chronic, but may be acute and reversible.
Left Heart Failure Forward; reduced CO Undue tachycardia, cold intolerance, fatigue, orthopnea, paroxysmal noctural dyspnea, cough, bronchospasm. Increased pulmonary artery pressure and pulmonary edema with dyspnea on exertion, cough, S3 (gallop) heart sound heard
Right Heart Failure Backward; reduced venous return Venous hypertension and stasis, weight gain, fatigue, fullness in abdomen, increased pulmonary artery pressures with peripheral edema (weight gain, venous stasis, pitting edema), anorexia Pleural effusion (R>L)
Respiratory Alkalosis pH incr, PaCO2 decr, HCO3 WNL Cause: alveolar hyperventilation Signs: dizziness, syncope, tingling, numbness, early tetany
Respiratory Acidosis pH decr, PaCO2 incr, HCO3 WNL Cause: alveolar hypoventilation Signs: Early = anxiety, restlessness, dyspnea, headache. Late = confusion, coma, somnolence.
Metabolic Alkalosis pH incr, HCO3 incr, PaCO2 WNL Causes: bicarbonate ingestion, vomiting, diuretics, adrenal disease Signs: vague symptoms weakness, mental dullness, possibly early tetany
Metabolic Acidosis pH decr, HCO3 decr, PaCO2 WNL Causes: diabetic, lactic, or uremic acidosis, prolonged diarrhea Signs: secondary hyperventilation, nausea, lethargy, coma
Created by: cdesai