Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Eiman Ghaffarpasand, M.D. [2]
Abbreviations: ABG= Arterial blood gas, ANP= Atrial natriuretic peptide, BNP= Brain natriuretic peptide, CBC= Complete blood count, COPD= Chronic obstructive pulmonary disease, CRP= C-reactive protein, CT= Computed tomography, CXR= Chest X-ray, DVT= Deep vein thrombosis, ESR= Erythrocyte sedimentation rate, HRCT= High Resolution CT, IgE= Immunoglobulin E, LDH= Lactate dehydrogenase, PCWP= Pulmonary capillary wedge pressure.
| Diseases
|
Cyanosis
|
Clinical manifestations
|
Para-clinical findings
|
Gold standard
|
Additional findings
|
| Symptoms
|
Physical examination
|
| Lab Findings
|
Imaging
|
| Peripheral
|
Central
|
Dyspnea
|
Fever
|
Chest pain
|
Clubbing
|
Peripheral edema
|
Auscultation
|
CBC
|
ABG
|
Electrolytes
|
Other
|
X-ray
|
CT scan
|
Other
|
| Pulmonary diseases
|
Airway disorder
|
Bacterial tracheitis[1]
|
+
|
–
|
+
|
+
|
+
|
–
|
–
|
Inspiratory stridor
|
Leukocytosis
|
Normal
|
Normal
|
Blood culture, Gram stain
|
Irregular tracheal margin
|
Normal
|
Steeple sign (confusing)
|
Laryngotracheobronchoscopy
|
Brassy cough, Hoarseness
|
| Parenchymal disorder
|
Alveolitis[2]
|
+/-
|
+
|
+
|
+
|
+
|
+/-
|
–
|
Wheeze, Crackles
|
Leukocytosis, Eosinophilia
|
↓O2, ↑CO2
|
Normal
|
↑ESR, ↑CRP
|
Scattered opacities, Fine reticulation
|
Homogeneous ground-glass opacity
|
–
|
HRCT PLUS Clinical findings
|
Malaise, Chills, Headache
|
| Cystic fibrosis[3]
|
+
|
–
|
+
|
+/-
|
+/-
|
+
|
–
|
Wheeze, Crackles
|
Normal
|
↓O2, ↑CO2
|
Increased sweat chloride
|
Sweat chloride test
|
Hyperinflation, Nodules
|
Peribronchial thickening, Bronchiectasis
|
–
|
Sweat chloride test
|
Absent vas deferens
|
| COPD
(Severe emphysema)[4]
|
+
|
–
|
+
|
+/-
|
+
|
+/-
|
+/-
|
Reduced breath sounds, Wheeze, Inspiratory crackles
|
Polycythemia
|
↓O2, ↑CO2
|
Normal
|
Alpha 1-antitrypsin test
|
Elongated heart, Flattened diaphragms, Prominent hilar vasculature
|
Bullae
|
–
|
HRCT
|
Pulmonary hypertension, Right heart failure
|
| Pulmonary vascular disorders
|
Massive pulmonary embolism[5]
|
+
|
–
|
+
|
+/-
|
+
|
–
|
+/-
|
Reduced breath sounds, Crackles, Loud P2
|
Leukocytosis
|
↓O2, ↑CO2, Respiratory acidosis
|
Normal
|
D-dimer, BNP
|
Fleischner sign, Hampton hump, Westermark sign, Pleural effusion
|
Filling defects in the pulmonary vasculature
|
Spiral CT pulmonary angiogram
|
Spiral CT pulmonary angiogram
|
Tachycardia, Shock, Pulmonary hypertension
|
| Cardiac diseases
|
Acquired disorders
|
Heart failure[6]
|
+
|
–
|
+
|
+/-
|
+
|
–
|
+
|
Coarse crackles, S3
|
Anemia
|
↓O2, ↑CO2
|
Hyponatremia, Hypokalemia, Hypomagnesemia
|
Elevated BNP
|
Pleural effusion, Cardiomegaly Kerley B lines
|
Normal
|
Radioisotope scan
|
Echocardiography
|
Generalized edema, Hepatomegaly
|
| Hematologic diseases
|
Polycythemia[7]
|
+
|
+
|
+
|
+/-
|
+/-
|
+
|
–
|
Normal
|
↑RBC, ↑WBC, ↑HGB, ↑Plt
|
↓O2
|
Hyperkalemia
|
↑Leukocyte alkaline phosphatase, ↑Ferritin, ↑Erythropoietin
|
AVM, COPD, pulmonary hypertension
|
Normal
|
Abdominal ultrasound or renal vascular studies for ruling out renal artery stenosis
|
RBC mass (RCM) and plasma volume measurement
|
Itchiness, Headache. Dizziness. Blurred vision
|
| Miscellaneous
|
Septic shock[8]
|
+
|
–
|
+
|
+
|
+/-
|
–
|
–
|
Rales, crackles, Wheeze, Pleural friction rub
|
Leukocytosis with neutrophilia
|
↓O2, ↑CO2, Metabolic acidosis
|
Hyperkalemia
|
↑ESR, ↑CRP
|
Consolidation
|
Pulmonary infiltration
|
Echocardiography
|
Blood culture
|
Chills, Hypothermia, Loss of consciousness
|
References
- ↑ Liston SL, Gehrz RC, Siegel LG, Tilelli J (August 1983). “Bacterial tracheitis”. Am. J. Dis. Child. 137 (8): 764–7. PMID 6869336.
- ↑ Lee JS, Im JG, Ahn JM, Kim YM, Han MC (August 1992). “Fibrosing alveolitis: prognostic implication of ground-glass attenuation at high-resolution CT”. Radiology. 184 (2): 451–4. doi:10.1148/radiology.184.2.1620846. PMID 1620846.
- ↑ “Cystic fibrosis – Genetics Home Reference”.
- ↑ Qureshi H, Sharafkhaneh A, Hanania NA (2014). “Chronic obstructive pulmonary disease exacerbations: latest evidence and clinical implications”. Ther Adv Chronic Dis. 5 (5): 212–27. doi:10.1177/2040622314532862. PMC 4131503. PMID 25177479.
- ↑ Bĕlohlávek J, Dytrych V, Linhart A (2013). “Pulmonary embolism, part I: Epidemiology, risk factors and risk stratification, pathophysiology, clinical presentation, diagnosis and nonthrombotic pulmonary embolism”. Exp Clin Cardiol. 18 (2): 129–38. PMC 3718593. PMID 23940438.
- ↑ Inamdar AA, Inamdar AC (2016). “Heart Failure: Diagnosis, Management and Utilization”. J Clin Med. 5 (7). doi:10.3390/jcm5070062. PMC 4961993. PMID 27367736.
- ↑ Spivak JL (February 2002). “The optimal management of polycythaemia vera”. Br. J. Haematol. 116 (2): 243–54. PMID 11841424.
- ↑ Hotchkiss RS, Moldawer LL, Opal SM, Reinhart K, Turnbull IR, Vincent JL (2016). “Sepsis and septic shock”. Nat Rev Dis Primers. 2: 16045. doi:10.1038/nrdp.2016.45. PMC 5538252. PMID 28117397.
