Clinical Assessment of the Older Breathless Patient

Abstract

It should not be construed as unusual to discuss breathlessness in an older patient presenting to a Zambian health institution today. Our Millennium Development Goals (MDGs) include eradication of poverty and hunger and decreasing childhood mortality by 2015 (I). If achieved, a safe assumption is that there will be more people surviving into adulthood thus increasing the older age group. Approximately 2.4% of our 10 million population are 65 years and over (2). If this age group had complex comorbidities, the appropriate specialist care would be provided by a multidisciplinary team lead by a Geriatrician. It is therefore harmless to lean about how to look after these millennium survivors when they present with common medical symptoms. One of these symptoms is breathlessness ordyspncea. The American Thoracic Society in 2003 defined dyspnoea as "a subjective experience of breathing discomfort that consists of qualitatively distinct sensations that vary in intensity". The nomenclature is fluid. The summary article below is intended to be a reminder of an organised bedside clinical approach to assessing a patient with this common symptom. The epidemiology of this symptom in the Zamhian health sector is unknown. It would be difficult to quantify. A)so, it's not clearly known what the accurate equivalent vernacular description. sare for dyspnoea. This should not preclude the need for one to have the knowledge to rapidly assess a potentially serious underlying respiratory or cardiovascular disease. I will use breathlessness and dyspnoea interchangeably.