Smoking history and exposure should be assessed, and cessation should be encouraged regardless of duration of use. Care of patients with chronic dyspnea typically requires a multidisciplinary approach, which makes the primary care physician ideal for management. The six-minute walk test can be helpful in measuring the effect of ongoing intervention. There are three main treatment and management goals: correctly identify the underlying disease process and treat appropriately, optimize recovery, and improve the dyspnea symptoms. Final options include more invasive tests that should be done in collaboration with specialty help.

If no cause is identified, second-line noninvasive testing such as echocardiography, cardiac stress tests, pulmonary function tests, and computed tomography scan of the lungs is suggested. Approaching testing in stages beginning with first-line tests, including a complete blood count, basic chemistry panel, electrocardiography, chest radiography, spirometry, and pulse oximetry, is recommended. A detailed history and physical examination should begin the workup results should drive testing. The likeliest causes of dyspnea are disease states involving the cardiac or pulmonary systems such as asthma, chronic obstructive pulmonary disease, heart failure, pneumonia, and coronary artery disease. As a symptom, dyspnea is a predictor for all-cause mortality. It is considered chronic if present for more than one month. Dyspnea is a symptom arising from a complex interplay of diseases and physiologic states and is commonly encountered in primary care.

What causes diminished lung sounds