In the final part of our series David Howell, Richard Marshall, Hugh Montgomery, and Neil Goldsack explain how to manage elderly breathless patients
A breathless elderly patient will undoubtedly be one of the commonest emergencies that you are called to as a house officer. The aetiology behind this presentation is often diverse. One of the big problems with treating elderly breathless patients is that they often display multiple pathologies. Therefore, if you are called to see an elderly patient who is breathless and has multiple pathologies the same principles outlined in all the previous articles apply.
This is extremely common in those elderly people who have smoked or continue to smoke. The diagnosis of chronic obstructive airways disease is a clinical one, but it includes those patients who have chronic bronchitis and emphysema, and there is often a mixture of both. It is crucial to get an accurate history in these patients. Classically, the patient presents acutely breathless with a fever, with associated increasing cough and production of sputum, which may have been