Evaluation of dyspnea. Is it really present and, if so, why?

Subacute or chronic dyspnea can be one of the most difficult complaints to evaluate. Dyspnea may represent the complaint of a person who is poorly fit, one who is suffering from anxiety or from some organic dysfunction, or one who is looking for secondary gain. The objectives in evaluating these patients are to determine that dyspnea is truly present and, if it is, to diagnose the specific cause so appropriate treatment can be undertaken. Often a good general evaluation is definitive enough to direct the clinician to specific tests that reveal the underlying cause of dyspnea. Some patients, however, require specialized tests both to confirm dyspnea and to indicate specific organic dysfunction.