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CME

, Volume 16, Issue 6, pp 9–21 | Cite as

Herz oder Lunge?

Diagnostik und Management der unklaren Belastungsdyspnoe
  • H. WilkensEmail author
  • M. Held
CME Fortbildung
  • 139 Downloads

Zusammenfassung

Belastungsdyspnoe ist ein unspezifisches Symptom, dem vielfältige Ursachen zugrunde liegen können. Es kann schwierig sein, eine beginnende kardiale Erkrankung von einer pulmonalen Erkrankung oder Trainingsmangel zu differenzieren, auch eine Adipositas erschwert die Gesamtbeurteilung. Seltene Erkrankungen wie pulmonale Hypertonie mit Belastungsdyspnoe als Kardinalsymptom werden in der Regel erst spät diagnostiziert. Ausgangspunkt einer erfolgreichen Abklärung ist eine sorgfältige Anamnese. Die Kombination aus Symptomen und Befunden führt zur Differenzialdiagnose. Einfach verfügbare Basisuntersuchungen wie körperliche Untersuchung, EKG, Spirometrie und Labor helfen bei der Diagnosestellung. Bei ungeklärten Ursachen stehen die erweiterte Diagnostik wie Echokardiographie und Blutgasanalyse und schließlich Spezialuntersuchungen zur Verfügung. Spiroergometrie und Echokardiographie unter Belastung sowie Rechtsherzkatheter in Ruhe und ggf. unter Belastung durch erfahrene Untersucher erlauben die genaue Differenzierung.

Schlüsselwörter

Belastungseinschränkung Herzerkrankung Lungenerkrankung Pulmonale Hypertonie 

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Copyright information

© Springer Medizin Verlag GmbH, ein Teil von Springer Nature 2019

Authors and Affiliations

  1. 1.Medizinische Klinik V, Pneumologie, Beatmungsmedizin und UmweltmedizinUniversitätsklinikum des SaarlandesHomburg/SaarDeutschland
  2. 2.Standort Missioklinik, Innere Medizin, Pneumologie und Beatmungsmedizin, Onkologie und Umweltmedizin, KlinikumWürzburg MitteWürzburgDeutschland

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