[Rational approach and management of the dyspnoeic XXXX in general medical practice].

@entity1 @entity1353 @entity565 @entity120 @entity299 @entity1151 @entity1030
Dyspnea represents 3-4 % of consultations at primary care medicine (general medicine, emergency medicine) and is found in 14 % of the interviewed general population. It is defined as an abnormal and uncomfortable @entity1353 and can be classified according to the mode of appearance, the @entity1353 pattern or the rhythm. Different classifications are used to specify the severity of the situation: visual analog scale, functional classification of the New York Heart Association, @entity1353 modified scale from the Medical Research Council, ... Rare among young @entity1 , @entity1353 often hides @entity565 ; more prevalent among seniors, it is often secondary to chronic lung or @entity299 . The rational approach is the same in general medicine and in the emergency room. The management starts with an assessment of the severity of the @entity1 's clinical situation, via the early warning score. The critical @entity1 requires to be managed according to the progressive and cyclical ABCDE approach. For non-critical @entity1 , a traditional approach and a reasoned method are needed. In @entity1 suffering from @entity1030 ( @entity1030 ), the use of the Anthonissen criteria allows to orient toward a pulmonary superinfection or another cause of worsening @entity1353 (cardiac, ...). In case of suspected @entity1151 , the Geneva score and the modified Wells score help to separate low, intermediate or high probability cases of @entity1151 . D-dimers have a very good negative predictive value in the low and middle risk group and pulmonary CT angiography applies only to a smaller group of dyspnoeic @entity1 with a high probability of @entity1151 . Echocardiography has a prominent role to assess the LV systolic function, the search for @entity120 , the vascular filling state, etc. We speak of psychogenic @entity1353 after having excluded the potentially serious pathologies.
