The Coexistence of Heart and Lung Diseases in Patients with Chronic Dyspnoea that is Unexplained By Clinical Evaluation
1Department of Chest Diseases, Faculty of Medicine, Hacettepe University, Ankara, Turkey
2Department of Internal Medicine, Faculty of Medicine, Hacettepe University, Ankara, Turkey
3Department of Cardiology, Faculty of Medicine, Gaziosmanpasa University, Tokat, Turkey
4Department of Chest Diseases, Faculty of Medicine, Gaziosmanpaşa University, Tokat, Turkey
5Department of Biostatistics and Medical Informatics, Faculty of medicine, Sakarya University, Sakarya, Turkey
J Clin Pract Res 2013; 35(2): 63-67 DOI: 10.5152/etd.2013.26
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Abstract

Objective[|]An understanding of the causes of dyspnoea can reduce morbidity and mortality. It may be difficult to decide whether dyspnoea is secondary to heart or lung disease. The objective of this study was to evaluate the coexistence of heart and lung diseases in patients with chronic dyspnoea, when clinical evaluation was not helpful.[¤]Materials and Methods[|]We conducted a retrospective review of 250 patients with chronic dyspnoea (>1 month). Patients were selected according to the following inclusion criteria: patients presented with a complaint of chronic dyspnoea; clinical evaluation was not sufficient; and both spirometry and TTE had been performed within 1 month.[¤]Results[|]Eighty-three percent of the patients had a diagnosis of heart and/or lung diseases. Ninety-five (38%) of the 250 patients with chronic dyspnoea had lung and heart diseases concomitantly. Diastolic heart failure was the most common heart
disease seen with COPD or asthma. The most common lung diseases were COPD and asthma. One hundred and fifty-five of the patients had a heart disease, with diastolic heart failure being the most common.[¤]Conclusion[|]When it was unclear whether the chronic dyspnoea was of a heart and/or lung origin based on clinical evaluation,
more than one-third of the patients with chronic dyspnoea were shown to have coexisting lung and heart disease.[¤]


Klinik Olarak Kronik Dispne Nedenine Karar Verilemediği Durumlarda Hem Kalp Hem Akciğer Hastalığının Varlığı
1Department of Chest Diseases, Faculty of Medicine, Hacettepe University, Ankara, Turkey
2Department of Internal Medicine, Faculty of Medicine, Hacettepe University, Ankara, Turkey
3Department of Cardiology, Faculty of Medicine, Gaziosmanpasa University, Tokat, Turkey
4Department of Chest Diseases, Faculty of Medicine, Gaziosmanpaşa University, Tokat, Turkey
5Department of Biostatistics and Medical Informatics, Faculty of medicine, Sakarya University, Sakarya, Turkey
Journal of Clinical Practice and Research 2013; 2(35): 63-67 DOI: 10.5152/etd.2013.26

Amaç[|]Dispneli hastalarda olası nedenlerin bilinmesi hastanın mortalite ve morbiditesini azaltabilir. Bazı hastalarda dispne nedeni kalp orijinli mi akciğer orijinli mi karar vermek zor olabilmektedir. Çalışmamızda klinik olarak kronik dispne nedeni kalp orijinli mi akciğer orijinli mi karar verilemeyen hastalarda ekokardiyografi ve spirometri yardımıyla hem kalp hem akciğer hastalığı varlığını değerlendirmeyi amaçladık.[¤]Gereç ve Yöntem[|]Kronik dispneli (>1 ay) 250 hastayı içeren retrospektif çalışmadır. Kronik dispne şikayeti olan, klinik değerlendirmeyle kalp ve/veya akciğer hastalığı olup olmadığına karar verilemeyen, 1 ay içinde hem spirometri hem de ekokardiyografik değerlendirilmesi yapılmış olan hastalar çalışmaya dahil edilmiştir.[¤]Bulgular[|]Hastaların %83’ünün kalp ve/veya akciğer hastalığı mevcuttu. Hastaların 95’inde (38%) kalp ve akciğer hastalığı eş zamanlı izlenmekteydi. Kronik dispne nedeni olarak en sık izlenilen akciğer hastalıkları KOAH ve astımdı. KOAH ve astımlı hastalarda diyastolik kalp yetmezliği en sık izlenilen kalp hastalığıydı. Hastaların 155’i bir kalp hastalığına sahipken en sık izlenilen kalp hastalığı diyastolik kalp yetmezliğiydi.[¤]Sonuç[|]Kronik dispne nedeni kalp ve/veya akciğer orijinli mi klinik değerlendirmeyle karar verilemediğinde, kronik dispneli hastaların yaklaşık 1/3’ünün hem kalp hem de akciğer hastalığına sahip olduğu görülmüştür.[¤]