Medical history (history of illness) represents an important component in the diagnosis of dyspnea (shortness of breath). Family history
- What is the general health of your family members?
- Are there any cardiovascular or respiratory diseases in your family that are common?
Social history
- What is your profession?
- Are you exposed to harmful working substances in your profession?
Current medical history/systemic medical history (somatic and psychological complaints).
- How long has the shortness of breath been present?
- Graduation of pulmonary dyspnea (lung-related shortness of breath) according to the modified Medical Research Council (MRC) suggestions:
- Grade 0: “I never have dyspnea except on vigorous exertion.”
- Grade 1: “I have shortness of breath when walking fast or walking uphill with a slight incline”
- Grade 2: “I walk slower than peers when walking on level ground or require breaks at self-selected speeds”
- Grade 3: “I require a break due to shortness of breath when walking on level ground after 100 m or a few minutes”
- Grade 4: “I am too short of breath to leave the house or to get dressed or undressed”
- Is the shortness of breath
- Come on suddenly?
- Episodic (temporary)?
- Slowly progressive (advancing)?
- Rapidly progressive (advancing)?
- What is the dyspnea?
- When breathing in?
- Exhale?
- At rest?
- Under load?
- Cough-dependent?
- Was there a direct trigger?
- Is the dyspnea seizure or positional?
- How many pillows do you use to sleep?
- Can you lie flat without getting too little air?
- Did the shortness of breath occur from one breath to the next? *
- How severe is the shortness of breath?
- Do you have other symptoms such as fever, cough, etc.? *
- Do you experience any viscous sputum? Coughing fits? *
- Does a feeling of tightness in the chest then also occur? *
- When do these symptoms occur? Depending on the time of year? Depending on other factors?
- Have you had a respiratory infection recently?
- Do you have calf pain?
- Do you have a lot of stress?
Vegetative anamnesis including nutritional anamnesis.
- Do you smoke? If yes, how many cigarettes, cigars or pipes per day?
- Is there smoking in your neighborhood?
- Do you live in the city or in the countryside (in terms of air pollution)?
- Do you drink alcohol? If so, what drink(s) and how many glasses per day?
- Do you use drugs? If yes, what drugs and how often per day or per week?
- Has there been any change in your appetite?
- Have you noticed any unwanted change in weight?
- Have you noticed any changes in digestion and/or water excretion?
- Do you suffer from sleep disturbances?
Self-history
- Pre-existing conditions (asthma, chronic obstructive pulmonary disease (COPD), heart disease).
- Surgeries
- Radiotherapy
- Allergies
- Environmental history (Are you exposed to metal salts, wood or plant dusts, or other chemicals (occupational or personal)?)
Medication history
- Antineoplastic agents (other antineoplastic agents [eg, protein kinase inhibitors], antimetabolites).
- Amiodarone (antiarrhythmic agent) → interstitial pneumonitis (collective term for any form of lung inflammation (pneumonia) that affects the interstitium or intercellular space rather than the alveoli (pulmonary alveoli))
- Beta-blockers, non-selective (propranolol, pindolol, carvedilol).
- Cox inhibitors (e.g., acetylsalicylic acid, indomethacin) – inhibition of cyclooxygenases (COX) increases the conversion of arachidonic acid from lipoxygenase to leukotrienes, which can trigger an asthma attack
- Monoclonal antibodies – pertuzumab
- MTOR inhibitors (everolimus, temsirolimus).
- Nitrofurantoin (antibiotic).
- Opioids (painkillers that have an analgesic effect at the so-called opioid receptors; e.g., morphine).
- X-ray contrast media (as an immediate reaction).
- Platelet aggregration inhibitors (e.g.B. acetylsalicylic acid, ticagrelor).
* If this question has been answered with “Yes”, an immediate visit to the doctor is required! (Data without guarantee)
