Summary
Definition
History and exam
Key diagnostic factors
- shortness of breath
- cough
- hemoptysis
- wheeze
- stridor
Other diagnostic factors
- hoarseness
- orthopnea
- dysphagia
- chest pain
- anxiety
- tachypnea
- tachycardia
- accessory muscle use
- cyanosis
- crackles
Risk factors
- lung cancer
- primary airway malignancy
- smoking
- artificial airways
- tracheobronchial stents
- transtracheal oxygen catheters
- lung transplantation
- neurocognitive and neuromuscular disorders
- relapsing polychondritis
- granulomatosis with polyangiitis (formerly known as Wegener granulomatosis)
- tracheobronchomalacia
- endobronchial infections
- extrathoracic and distant malignancies
Diagnostic investigations
1st investigations to order
- chest x-ray
Investigations to consider
- bronchoscopy (flexible and/or rigid)
- CT chest
- MRI of chest
- flow-volume loops (FVL)
- spirometry
Emerging tests
- endobronchial ultrasound (EBUS)
Treatment algorithm
acute presentation
subacute presentation
Contributors
Authors
Jose Fernando Santacruz, MD, FCCP, DAABIP

Medical Director
Bronchoscopy & Interventional Pulmonology
Houston Methodist Lung Center
Houston Methodist Hospital
Houston
TX
Disclosures
JFS is a consultant for Boston Scientific and is the author of several studies referenced in this topic.
Peer reviewers
Krishna M. Sundar, MD
Adjunct Assistant Professor
University of Utah
Director
Pulmonary & Critical Care Research
IHC Urban South Intermountain Utah Valley Pulmonary Clinic
Provo
UT
Disclosures
KMS declares that he has no competing interests.
Andrew Parfitt, MBBS, FFAEM
Clinical Director
Acute Medicine
Associate Medical Director
Consultant Emergency Medicine
Guy's and St Thomas' NHS Foundation Trust
Clinical Lead and Consultant
Accident Emergency Medicine
St Thomas' Hospital
London
UK
Disclosures
AP declares that he has no competing interests.
Differentials
- COPD exacerbation
- Asthma exacerbation
- Pneumonia
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