Differential Diagnosis for Shortness of Breath (SOB)
Single Most Likely Diagnosis
- Chronic Obstructive Pulmonary Disease (COPD): This is a common condition, especially in smokers, that can cause chronic shortness of breath due to airflow limitation. The symptoms and history often point towards this diagnosis in the appropriate demographic.
Other Likely Diagnoses
- Asthma: A condition characterized by episodic airway constriction, leading to wheezing, cough, and shortness of breath. It's common and can be acute or chronic.
- Heart Failure: Reduced heart function can lead to fluid buildup in the lungs (pulmonary edema), causing shortness of breath. This is especially likely in patients with a history of heart disease.
- Pneumonia: An infection of the lungs that can cause cough, fever, and shortness of breath. It's a common and potentially serious condition.
- Pulmonary Embolism: A blood clot in the lungs, which can cause sudden onset of shortness of breath, often accompanied by chest pain and other symptoms.
Do Not Miss Diagnoses
- Pulmonary Embolism: Although listed under other likely diagnoses, it's crucial to emphasize its inclusion here due to its high mortality rate if missed. Prompt diagnosis and treatment are essential.
- Cardiac Tamponade: Fluid accumulation in the sac around the heart can compress it, severely impairing its function and leading to sudden, severe shortness of breath.
- Tension Pneumothorax: Air in the chest cavity can cause the lung to collapse, leading to severe respiratory distress and potentially death if not immediately treated.
- Acute Coronary Syndrome (ACS): Conditions such as myocardial infarction can cause shortness of breath due to reduced heart function or ischemia.
Rare Diagnoses
- Lymphangitic Carcinomatosis: Spread of cancer to the lymphatic vessels in the lungs, causing shortness of breath.
- Eosinophilic Pneumonia: A rare condition characterized by an accumulation of eosinophils in the lungs, leading to inflammation and respiratory symptoms.
- Sarcoidosis: An autoimmune disease that can affect the lungs, causing shortness of breath among other symptoms.
- Idiopathic Pulmonary Fibrosis: A chronic and progressive lung disease of unknown cause, characterized by scarring of lung tissue, leading to shortness of breath.