Congenital malformations, deformities, and chromosomal abnormalities (Q00-Q99).
- Laryngomalacia – pathologic softening of the larynx.
- Laryngeal sail formations (English : web).
- Subglottic stenosis (laryngeal narrowing).
- Recurrent paresis (vocal cord paralysis).
Respiratory system (J00-J99)
- Acute respiratory distress syndrome (ARDS) – acute progressive respiratory failure.
- Aspiration pneumonia1 (form of pneumonia resulting from aspiration of foreign bodies or fluids).
- Bronchial asthma1, 2
- Atelectasis – reduction/absence of air in the alveoli (air sacs).
- Exercise-induced bronchoconstriction (BIB; bronchoconstriction); common in children; symptoms include dyspnea (shortness of breath), chest tightness, whistling breathing (“wheezing”), or coughing during or after exercise (develop within 15 min of exercise and subside within 1 h); more than one-third of all children show a marked decrease in one-second capacity (FEV1; English : Forced Expiratory Volume in 1 second; Forced one-second volume = second air) ≥ 10 percent after physical exertion (e.g., sports).
- Bronchiectasis2 (irreversible saccular or cylindrical dilatation of the medium-sized airways (bronchi)).
- Bronchiolitis obliterans – obstructive respiratory disorder (= increase in flow resistance); characterized by inflammatory and fibrosing wall thickening.
- Bronchitis (inflammation of the larger branched airways/bronchi).
- Chronic obstructive pulmonary disease (COPD)2; acute exacerbation1 (marked worsening of symptoms); fixed obstruction of the deep airways; patients > 40 years of age.
- Epiglottitis (epiglottitis; symptoms: barking, dry, irritable cough that can lead to life-threatening respiratory distress)
- Exogenous allergic alveolitis (EAA) – allergic inflammation of the alveoli (alveolitis) caused by inhalation of fine dust.
- Glottic edema (laryngeal edema).
- Idiopathic interstitial pneumonia
- Interstitial pneumonitis (a collective term for any form of pneumonia (pneumonia) that affects the interstitium or intercellular space rather than the alveoli (air sacs)) due to amiodarone (antiarrhythmic drug)
- Laryngospasm – spasmodic constriction of the glottis.
- Pulmonary fibrosis – connective tissue remodeling of the lung tissue with subsequent functional impairment.
- Pulmonary edema – accumulation of water in the lungs.
- Pleural effusion1 – accumulation of fluid between the lung and pleura.
- Pleurisy (inflammation of the pleura)
- Pneumonia1 (pneumonia); patients > 65 years (about 80%).
- Pneumothorax – air in the gap between the lung and pleura, where there is normally no air; leads to lung collapse.
- Pseudocroup – laryngitis (inflammation of the larynx), which leads mainly to swelling of the mucous membrane below the vocal cords.
- Recurrent paresis (vocal cord paralysis), bilateral (unilateral recurrent paresis usually does not cause dyspnea).
- SARS (Severe Acute Respiratory Syndrome; severe acute respiratory syndrome) – respiratory infection with SARS-CoV-1 coronavirus (synonyms: SARS-associated coronavirus, SARS-CoV) results in atypical pneumonia (pneumonia); lethality (mortality rate) 10%.
- Tracheitis – inflammation of the trachea.
- Trachelastenosis (narrowing of the trachea)
- Vocal cord dysfunction (Engl. Vocal Cord Dysfunction, VCD) – leading symptom of VCD: Abruptly occurring, dyspnea-inducing laryngeal obstruction (laryngeal constriction usually experienced in the cervical or upper tracheal region), usually during inspiration (inhalation), which can lead to dyspnea of varying intensity, inspiratory stridor (breath sounds on inhalation), no bronchial hyperresponsiveness (airway hypersensitivity in which the bronchi abruptly constrict), normal lung function; cause: Paradoxical, intermittent glottis closure; especially in younger women (→ seizure-like dyspnea; often preceded by a coughing fit).
Blood, hematopoietic organs – immune system (D50-D90).
- Anemia2 (anemia)
- Sarcoidosis – inflammatory multisystem disease, the cause of which is still unclear.
Endocrine, nutritional and metabolic diseases (E00-E90).
- Obesity (overweight) – DD: patients with classic bronchial asthma who are overweight or overweight patients with respiratory symptoms but without sensitization or Th2 immune response.
- Acidosis, respiratory – respiratory acidosis.
- Diabetic ketoacidosis1 (severe metabolic derailment (ketoacidosis) due to insulin deficiency).
- Hashimoto’s thyroiditis – autoimmune disease that leads to chronic inflammation of the thyroid gland.
- Hypothyroidism (underactive thyroid gland).
- Cystic Fibrosis (ZF) – genetic disease with autosomal recessive inheritance characterized by the production of secretions in various organs to be tamed.
- Goiter (enlargement of the thyroid gland or goiter).
- Tracheobronchial amyloidosis (most common form of pulmonary amyloidosis).
Malformations (congenital), deformities, and chromosomal abnormalities (Q00-Q99).
- Thoracic deformity – malformation of the chest such as kyphoscoliosis.
Cardiovascular system (I00-I99).
- Aortic aneurysm, thoracic – pathologic (abnormal) bulge of the arterial wall.
- Aortic dissection (synonym: aneurysm dissecans aortae) – acute splitting (dissection) of the wall layers of the aorta (aorta), with a tear of the inner layer of the vessel wall (intima) and a hemorrhage between the intima and the muscular layer of the vessel wall (outer media), in the sense of an aneurysm dissecans (pathological expansion of the artery).
- Aortic stenosis2 (narrowing of the outflow tract of the left ventricle).
- Cor pulmonale1,2 – dilatation (widening) and/or hypertrophy (enlargement) of the right ventricle (main chamber) of the heart as a result of pulmonary hypertension (increase in pressure in the pulmonary circulation)
- Chronic thromboembolic pulmonary hypertension/ pulmonary hypertension (CTEPH) due to recurrent (recurring) pulmonary embolism (chronic thromboembolism):The 2-year prevalence (disease incidence) for chronic thromboembolic pulmonary hypertension (CTEPH) is circa 1-4%.Symptoms: Exertional dyspnea (shortness of breath on exertion), chest pain, fatigue, edema (water retention), or syncope (brief loss of consciousness); Diagnosis: echocardiography, followed by a ventilation perfusion scintigram; if necessary. also a right heart catheterization; therapy: surgical excision of the thrombotic material, i.e. pulmonary endarterectomy using the heart-lung machine; a new treatment option is pulmonary balloon angioplasty (pulmonary artery balloon angioplasty, BPA).
- Endocarditis (inflammation of the heart lining).
- Heart failure (cardiac insufficiency; acute left heart failure1; decompensated heart failure2); other typical symptoms include fatigue, decreased performance, and fluid retention
- Cardiac vitium (heart defect)
- Hypertrophic obstructive cardiomyopathy – heart muscle disease that may be associated with the following symptoms and complications: Dyspnea (shortness of breath), angina (“chest tightness”; sudden onset of pain in the heart area), cardiac arrhythmias, syncope (momentary loss of consciousness), and sudden cardiac death (PHT).
- Cardiomyopathy (heart muscle disease).
- Coronary artery disease (CAD; coronary artery disease): exertional dyspnea as an atypical expression of CAD.
- Coronary microvascular dysfunction (MVD): mismatch between myocardial oxygen demand and supply; likely caused by chronic inflammation (inflammation); risk factors: Hypertension (high blood pressure), diabetes mellitus, hypercholesterolemia (high blood cholesterol); Diagnosis: CT coronary angiography and PET measurement of myocardial flow reserve [MVD: lack of vasodilation (vasodilatation) and/or increased vasoconstriction (vasoconstriction)/spasm tendency]Note: Approx. 50% of all patients with suspected stenosing CAD do not show relevant stenoses (narrowing) on coronary angiography (radiological procedure that uses contrast agents to visualize the lumen (interior) of the coronary arteries (arteries that surround the heart in a wreath shape and supply blood to the heart muscle).
- Pulmonary embolism1 (occlusion of pulmonary vessels by a blood clot); recurrent pulmonary embolism2.
- Myocardial infarction (heart attack)
- Myocarditis (inflammation of the heart muscle)
- Pericardial effusion (pericardial effusion)
- Pulmonary hypertension (PH; pulmonary hypertension).
- Valvular heart disease (valvular defects: aortic stenosis, mitral regurgitation); onset at older ages.
- Atrial fibrillation (VHF)
Infectious and parasitic diseases (A00-B99).
- Encephalitis (inflammation of the brain).
- MERS-CoV (Middle East respiratory syndrome coronavirus); formerly called human betacoronavirus 2c EMC/2012 (HCoV-EMC, also human coronavirus EMC, was initially called “new coronavirus” NCoV); from the coronavirus family (Coronaviridae); first identified in 2012; causes severe respiratory infection; course: Acute onset flu-like illness that can progress to pneumonia during the first week and later to acute respiratory distress syndrome with renal failure; lethality (mortality rate) 50%.
- Sars-CoV-2 (synonyms: novel coronavirus (2019-nCoV); 2019-nCoV (2019-novel coronavirus; coronavirus 2019-nCoV); Wuhan coronaviru) – this respiratory infection with Sars-CoV-2 results in atypical pneumonia (pneumonia), which is called COVID-19 (Engl. coronavirus disease 2019, coronavirus disease-2019) has received; lethality (mortality rate) 2-3 %.
- Viral, bacterial and rarely mycotic diseases, unspecified.
Mouth, esophagus (food pipe), stomach, and intestines (K00-K67; K90-K93).
- Hiatal hernia2 (hiatal hernia).
Musculoskeletal system and connective tissue (M00-M99).
- Kyphoscoliosis – dorsal (“toward the back of the body”) curvature of the spine (“hunchback“) with concomitant lateral curvature (scoliosis).
- Muscular diseases (eg, muscular dystrophy Duchenne).
- Ankylosing spondylitis (ankylosing spondylitis) – disease affecting the spine and its joints.
- Diaphragmatic hypertension
Neoplasms – tumor diseases (C00-D48)
- Malignant neoplasm, unspecified, resulting in upper influence congestion.
- Bronchial carcinoma (lung cancer).
- Lung metastases (daughter tumors of tumors in the lungs).
- Neoplasms of the oropharynx and hypopharynx (mouth part of the pharynx and lower pharyngeal region) and the larynx (larynx).
Psyche – Nervous System (F00-F99; G00-G99).
- Amyotrophic lateral sclerosis (ALS) – neurologic disease in which progressive muscle atrophy occurs.
- Anxiety disorders
- Endplate diseases (e.g., myasthenia gravis (MG; synonyms: myasthenia gravis pseudoparalytica; MG); rare neurological autoimmune disease in which specific antibodies against the acetylcholine receptors are present, with characteristic symptoms such as abnormal load-dependent and painless muscle weakness, asymmetry, in addition to local, also a temporal variability (fluctuation) in the course of hours, days, resp. Weeks, an improvement after recovery or rest periods; clinically can be differentiated a purely ocular (“affecting the eye”), a faciopharyngeal (face (Facies) and pharynx (pharynx)) emphasized and a generalized myasthenia; about 10% of cases already show a manifestation in childhood).
- Hyperventilation1 – increased breathing in excess of the need.
- Neuromuscular diseases, unspecified.
- Neuropathies [e.g. E.g., Guillain-Barré syndrome (GBS; synonyms: Idiopathic polyradiculoneuritis, Landry-Guillain-Barré-Strohl syndrome); two courses: acute inflammatory demyelinating polyneuropathy or chronic inflammatory demyelinating polyneuropathy (disease of the peripheral nervous system); idiopathic polyneuritis (diseases of multiple nerves) of spinal nerve roots and peripheral nerves with ascending paralysis and pain; usually occurs after infections [very rare]]
- Panic disorder (psychogenic dyspnea).
- Somatization disorder (physical complaints referred to, which can not or not sufficiently be attributed to an organic disease).
- Diaphragmatic paresis (diaphragmatic paralysis), bilateral.
Symptoms and abnormal clinical and laboratory findings not elsewhere classified (R00-R99).
- Allergic reaction
- Ascites (abdominal fluid)
- Hemoptysis (coughing up blood)
- Cardiomegaly (abnormal enlargement of the heart).
Genitourinary system (kidneys, urinary tract – reproductive organs) (N00-N99).
- Chronic renal insufficiency (kidney weakness).
Injuries, poisonings, and other consequences of external causes (S00-T98).
- Allergic (histamine-mediated) and nonallergic (kinin-mediated) edema (swelling of the mucous membranes of the oral cavity, pharynx (throat), and larynx)
- Inhaled foreign bodies
- Iatrogenic (caused by the physician), e.g., as a result of intubation (insertion of a tube (a hollow probe) into the trachea/trachea) and previous tracheotomies (tracheotomy)
- Rib fractures (rib fractures).
- Rib contusion
- Traumatic laryngeal injury (laryngeal damage).
Other differential diagnoses
- Smoker
- Pregnancy
- Lack of training
Medication
- Antineoplastic agents (other antineoplastic agents [e.g., protein kinase inhibitors], antimetabolites).
- Amiodarone (antiarrhythmic agent) → interstitial pneumonitis (collective term for any form of pneumonia (pneumonia) that affects the interstitium rather than the alveoli)
- Beta-blockers, nonselective (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., acetylsalicylic acid, ticagrelor).
1 Most common forms of acute dyspnea2 Most common forms of chronic dyspnea.
In bold, the 10 most common causes of dyspnea in a German hospital.
