Abstract：
:Chronic dyspnoea, or breathlessness for more than four weeks duration, is a common symptom in adults presenting to primary and tertiary care. It often presents a diagnostic challenge due to the wide spectrum of underlying disease, which is multifactorial in approximately one third of cases. Challenges in diagnosis include an often non-diagnostic clinical assessment, difficulty in selecting the most appropriate investigations and correct speciality referral for further diagnostic assessment. In patients presenting with chronic dyspnoea, history and physical examination are often non-specific with key findings more useful as negative predictive factors. There is a broad range of simple to specialised investigations that may be utilised in the diagnostic workup. Several diagnostic algorithms incorporating different tiers of investigations have been tested in studies of chronic dyspnoea patients but there is currently very limited data that test a diagnostic algorithm against standard clinical care. In this review we propose a diagnostic pathway with primary, secondary and tertiary level investigations for patients with chronic dyspnoea. This pathway is based on the combination of previously tested diagnostic algorithms in the literature, to assist clinicians in their diagnostic workup of chronic dyspnoea patients. Further research is needed to further evaluate diagnostic algorithms in this setting and to test this diagnostic pathway in clinical practice.
journal_name
J Thorac Disjournal_title
Journal of thoracic diseaseauthors
Ferry OR,Huang YC,Masel PJ,Hamilton M,Fong KM,Bowman RV,McKenzie SC,Yang IAdoi
10.21037/jtd.2019.10.53subject
Has Abstractpub_date
2019-10-01 00:00:00pages
S2117-S2128issue
Suppl 17eissn
2072-1439issn
2077-6624pii
jtd-11-S17-S2117journal_volume
11pub_type
杂志文章,评审abstract：BACKGROUND:Thoracic pleural empyema is a collection of pus within a thoracic cavity. In stage 2 (fibrinopurulent) and stage 3 (organizational), decortication is the only choice. But there is no consensus on whether to choose video-assisted thoracoscopic decortication (VATD) or open thoracotomy decortication (OTD). We s...
journal_title：Journal of thoracic disease
pub_type： 杂志文章
doi：10.21037/jtd.2017.06.109
更新日期：2017-07-01 00:00:00
abstract：BACKGROUND:Obstructive sleep apnoea (OSA) is the most common form of sleep-disordered breathing and a known risk factor for cardiovascular disease. We hypothesised that in patients with OSA the characteristics of nocturnal pulse rate (PR) are associated with changes in blood pressure and daytime sleepiness, following c...
journal_title：Journal of thoracic disease
pub_type： 杂志文章
doi：10.3978/j.issn.2072-1439.2014.05.09
更新日期：2014-06-01 00:00:00
abstract：Background:The subcategory "solid component of tumor" is a new criterion of tumor categories in the updated eighth edition of the TNM classification. Nevertheless, the predictors of lymph node metastasis among patients with clinical T1 adenocarcinoma, based on the TNM classification 8th edition, remain unclear. This st...
journal_title：Journal of thoracic disease
pub_type： 杂志文章
doi：10.21037/jtd.2020.03.74
更新日期：2020-05-01 00:00:00
abstract：Background:The incidence of conduction disturbances requiring permanent pacemaker (PPM) implantation following transcatheter aortic valve replacement (TAVR) have remained a common concern. The purpose of this study was to evaluate the impact of postprocedural PPM implantation following TAVR on clinical outcomes. Metho...
journal_title：Journal of thoracic disease
pub_type： 杂志文章
doi：10.21037/jtd.2019.12.02
更新日期：2019-12-01 00:00:00
abstract：:Approximately 30% to 50% of patients will develop ischemic mitral regurgitation (MR) after a myocardial infarction, which is a result of progressive left ventricular remodeling and dysfunction of the subvalvular apparatus, and portends a poor long-term prognosis. Surgical treatment is centered on mitral valve repair u...
journal_title：Journal of thoracic disease
pub_type： 杂志文章
doi：10.3978/j.issn.2072-1439.2016.01.27
更新日期：2016-01-01 00:00:00
abstract：Background:Robotic lobectomy is widely used for lung cancer treatment. So far, few studies have been performed to systematically analyze the learning curve. Our purpose is to define the learning curve to provide a training guideline of this technique. Methods:A total of 208 consecutive patients with primary lung cance...
journal_title：Journal of thoracic disease
pub_type： 杂志文章
doi：10.21037/jtd.2019.05.71
更新日期：2019-06-01 00:00:00
abstract：Background:Epidermal growth factor receptor tyrosine kinase inhibitors (EGFR-TKIs) have become important treatment options for non-small cell lung cancer (NSCLC) patients with EGFR sensitive mutation. However, the detection of EGFR driver mutation is impeded by the lack of adequate tumor tissues, histopathological type...
journal_title：Journal of thoracic disease
pub_type： 杂志文章
doi：10.21037/jtd.2019.05.22
更新日期：2019-05-01 00:00:00
abstract：Background:A standardized treatment algorithm for sternoclavicular joint infection management is lacking in the literature. While major risk factors for sternoclavicular joint infection, including immunosuppression, rheumatoid arthritis, type 2 diabetes, indwelling catheters, and intravenous drug use have been identifi...
journal_title：Journal of thoracic disease
pub_type： 杂志文章
doi：10.21037/jtd-20-1897
更新日期：2020-10-01 00:00:00
abstract：Background:Monitoring of trends in the use of the intensive care unit (ICU) and the outcomes of ICU patients is essential for the assessment of the effective use of ICU. This study aims to investigate the incidence and outcome of critical care admissions in Taiwan from 1997 to 2013. Methods:Patients >18 years who had ...
journal_title：Journal of thoracic disease
pub_type： 杂志文章
doi：10.21037/jtd.2018.07.131
更新日期：2018-08-01 00:00:00
abstract：Background:The recommended treatment duration for non-cavitary nodular bronchiectatic (NC-NB) Mycobacterium avium complex (MAC) lung disease (LD) is at least 12 months after culture conversion, but evidence supporting this is limited. This study investigated whether treatment for less than 12 months after culture conve...
journal_title：Journal of thoracic disease
pub_type： 杂志文章
doi：10.21037/jtd.2020.01.39
更新日期：2020-03-01 00:00:00
abstract：BACKGROUND:Esophagectomy is accompanied by a high postoperative complication rate. Minimally invasive esophageal surgery appears to be a promising technique that might be associated with a lower pulmonary morbidity rate. The objective of this study was to describe the implementation of minimally invasive esophageal sur...
journal_title：Journal of thoracic disease
pub_type： 杂志文章
doi：10.3978/j.issn.2072-1439.2012.09.05
更新日期：2012-10-01 00:00:00
abstract：Background:Trans-bronchoscope treatment for early stage small peripheral lung cancer, such as photodynamic therapy (PDT), has been investigated. However, despite the efficacy of PDT, light delivery issues limit its application. A method of administering mineral oil with a high refractive index (RI) was previously propo...
journal_title：Journal of thoracic disease
pub_type： 杂志文章
doi：10.21037/jtd-19-3887
更新日期：2020-07-01 00:00:00
abstract：:Due to its intrinsic characteristics, video assisted thoracic surgery (VATS) lobectomy is currently the recommended surgical approach for early stage lung cancer treatment. The importance of increasing the number of surgeons capable of performing VATS lobectomies is implicit and of utmost importance. In fact, the need...
journal_title：Journal of thoracic disease
pub_type： 杂志文章
doi：10.21037/jtd.2016.03.82
更新日期：2016-04-01 00:00:00
abstract：:Non-small-cell lung cancer (NSCLC) is a uniformly fatal disease and most patients will present with advanced stage. Treatment outcomes remain unsatisfactory, with low long-term survival rates. Standard treatment, such as palliative chemotherapy and radiotherapy, offers a median survival not exceeding 1 year. Hence, co...
journal_title：Journal of thoracic disease
pub_type： 杂志文章
doi：10.3978/j.issn.2072-1439.2010.12.03
更新日期：2011-03-01 00:00:00
abstract：:Ultrasound imaging has gained importance in pulmonary medicine over the last decades including conventional transcutaneous ultrasound (TUS), endoscopic ultrasound (EUS), and endobronchial ultrasound (EBUS). Mediastinal lymph node staging affects the management of patients with both operable and inoperable lung cancer ...
journal_title：Journal of thoracic disease
pub_type： 杂志文章,评审
doi：10.3978/j.issn.2072-1439.2015.09.40
更新日期：2015-09-01 00:00:00
abstract：Background:Various approaches and markers for marking the lungs prior to lung tumor resection have been reported. In clinical practice, the hook wire localization method is often used owing to the simplicity of the technique. However, although rare, this method is associated with air embolism, which can be lethal. Beca...
journal_title：Journal of thoracic disease
pub_type： 杂志文章
doi：10.21037/jtd.2020.01.06
更新日期：2020-03-01 00:00:00
abstract：Background:This study analyzes the outcomes of a one-stage hybrid procedure combining thoracic endovascular aortic repair (TEVAR) with extra-anatomic bypass in patients with distal aortic arch disease. Methods:This retrospective study collected 103 hybrid procedures combining TEVAR with extra-anatomic bypass (mean age...
journal_title：Journal of thoracic disease
pub_type： 杂志文章
doi：10.21037/jtd-20-2338
更新日期：2020-12-01 00:00:00
abstract：Background:A number of treatment modalities are available to patients with early non-small cell lung cancer (NSCLC) but there is inconsistency regarding their effects on survival. The associated survival of each treatment modality is crucial for patients in making informed treatment decisions. We aimed to examine the c...
journal_title：Journal of thoracic disease
pub_type： 杂志文章
doi：10.21037/jtd-20-1387
更新日期：2020-09-01 00:00:00
abstract：Background:Good compliance in chronic obstructive pulmonary disease (COPD) is of 'paramount importance' in reducing the occurrence of acute exacerbations, hospitalisation and mortality and in improving quality of life. However, a number of studies have confirmed that long-term compliance is low and often associated wit...
journal_title：Journal of thoracic disease
pub_type： 杂志文章
doi：10.21037/jtd.2018.09.126
更新日期：2018-10-01 00:00:00
abstract：:Bronchial thermoplasty (BT) is used in the treatment of severe refractory asthma. It has been found to be beneficial to long-term improvements in the rate of asthma exacerbation, quality of life questionnaire answers (AQLQ), hospitalization, and emergency room visits. Atelectasis and lung abscess as direct complicatio...
journal_title：Journal of thoracic disease
pub_type：
doi：10.21037/jtd.2018.09.116
更新日期：2018-10-01 00:00:00
abstract：Background:Chronic obstructive pulmonary disease (COPD) is one of the leading causes of mortality and morbidity around the world, with comorbidities in COPD being common and having a negative effect on survival. We investigate the effects of comorbidities on long-term survival of COPD patients. Methods:The study inclu...
journal_title：Journal of thoracic disease
pub_type： 杂志文章
doi：10.21037/jtd.2019.03.78
更新日期：2019-04-01 00:00:00
abstract：:Fatal hemoptysis is a serious complication of pulmonary tuberculosis, which can rarely be due to a bronchial aneurysm. Here, we present a case of fatal hemoptysis due to bronchial aneurysm occurred in a 59-year-old patient of Han ethnicity suffering from active pulmonary tuberculosis. Meanwhile, we perform a literatur...
journal_title：Journal of thoracic disease
pub_type：
doi：10.3978/j.issn.2072-1439.2014.04.07
更新日期：2014-06-01 00:00:00
abstract：:Transbronchial lung biopsy with a cryoprobe, or cryobiopsy, is a promising new bronchoscopic biopsy technique capable of obtaining larger and better-preserved samples than previously possible using traditional biopsy forceps. Over two dozen case series and several small randomized trials are now available describing e...
journal_title：Journal of thoracic disease
pub_type： 杂志文章,评审
doi：10.21037/jtd.2017.06.96
更新日期：2017-07-01 00:00:00
abstract：:The purpose of this article is to provide an overview of the epidemiology of COPD in India which is one of the most affected countries in the world and contributes significantly to the mortality and morbidity of this disease; to provide insights into the etiological determinants of COPD in India; comment on treatment ...
journal_title：Journal of thoracic disease
pub_type： 杂志文章
doi：10.3978/j.issn.2072-1439.2012.03.15
更新日期：2012-06-01 00:00:00
abstract：:ERBB2 mutations have been reported to occur in a subset of patients with lung adenocarcinomas or lung squamous cell carcinomas for some ethnicities, but it is unclear for Chinese patients with lung squamous cell carcinomas up to now. We retrospectively evaluated the status of ERBB2 mutations in a large cross-sectional...
journal_title：Journal of thoracic disease
pub_type： 杂志文章
doi：10.3978/j.issn.2072-1439.2014.03.20
更新日期：2014-05-01 00:00:00
abstract：BACKGROUND:Cytomegalovirus (CMV) pneumonia is a major cause of death in immunosuppressed patients. Despite the effective treatment with ganciclovir (GCV) and other antiviral agents, the mortality rate remains between 30% to 50%. Recently, the anti-malarial drug artesunate (ART) wasfound to exhibit significant anti-vira...
journal_title：Journal of thoracic disease
pub_type： 杂志文章
doi：10.3978/j.issn.2072-1439.2015.07.05
更新日期：2015-07-01 00:00:00
abstract：:The vascular structure related compression of esophagus is rather rare. Aberrant right subclavicular artery accounts for the majority of the rare entity, while the thoracic aorta aneurysm is a more dangerous type, called as dysphagia aortica. Delay in diagnosis and treatment of the dysphagia aortica predisposes to rup...
journal_title：Journal of thoracic disease
pub_type：
doi：10.3978/j.issn.2072-1439.2013.11.15
更新日期：2013-12-01 00:00:00
abstract：Background:The pathogenesis of atrial fibrillation (AF) remains unclear. Vascular endothelial growth factors (VEGFs) can stimulate fibrosis within the atrium and ventricle. We hypothesized that there is a relationship between the serum VEGFs/soluble vascular endothelial growth factor receptor (sVEGFRs) levels and AF in...
journal_title：Journal of thoracic disease
pub_type： 杂志文章
doi：10.21037/jtd.2019.11.32
更新日期：2019-12-01 00:00:00
abstract：:Transcatheter aortic valve implantation (TAVI) has gained widespread acceptance as a treatment option for patients at high risk for conventional aortic valve replacement. The most commonly used access site for TAVI is the common femoral artery. Yet, in a significant number of patients the transfemoral access is not su...
journal_title：Journal of thoracic disease
pub_type： 杂志文章,评审
doi：10.3978/j.issn.2072-1439.2015.07.27
更新日期：2015-09-01 00:00:00
abstract：:The Nuss procedure is a recently developed technique for correction of pectus excavatum. A 23-year-old female patient presented at our emergency department with clinical signs of cardiac tamponade, which required an emergency procedure. Sixteen months ago, she underwent the Nuss procedure with a single bar. Her preope...
journal_title：Journal of thoracic disease
pub_type：
doi：10.21037/jtd.2017.04.11
更新日期：2017-05-01 00:00:00
