Practical management of chronic breathlessness
Breathlessness is a common condition that is often undermanaged and distressing for patients
Medical students and junior doctors are trained in dealing with acute episodes of breathlessness, but chronic breathlessness is often neglected in the curriculum. It is an important condition to be able to recognise so that appropriate treatment can be delivered, but it is often unreported and undermanaged.1 Breathlessness, or dyspnoea, can be defined as an uncomfortable awareness of breathing.2 Chronic, refractory breathlessness, which persists in spite of optimal medical management of the underlying condition, is a common feature of advanced heart, lung, and neurological diseases, as well as cancer, and affects up to half of patients admitted to hospital.3 It can be terrifying for the patient and for those caring for them, including family members and clinical staff. Recognition and management of this distressing symptom, which is similar to pain, should be part of caring for patients.
Recognising breathlessness is important when assessing the severity and prognosis of disease. The