Dyspnoea caused by upper-airway obstruction: simple diagnosis by establishing a flow-volume loop

• Published in: Nederlands tijdschrift voor geneeskunde Vol. 150; no. 18; p. 993
• Main Authors: Kapteijns, E F G, Kwakkel-van Erp, J M, Vos, P J E, van den Elshout, F J J
• Format: Journal Article
• Language: Dutch
• Published: Netherlands 06.05.2006
• Subjects: Adult; Aged; Airway Obstruction - complications; Airway Obstruction - diagnosis; Carcinoma - complications; Dyspnea - diagnosis; Dyspnea - etiology; Esophageal Neoplasms - complications; Fatal Outcome; Humans; Lung Volume Measurements - methods; Male; Vocal Cord Paralysis - complications
• ISSN: 0028-2162

Three patients, men aged 72, 78 and 19 years, experienced shortness of breath and laboured breathing. All three had an upper-airway obstruction detected by a flow-volume loop and confirmed by bronchoscopy. The first patient had oesophageal carcinoma with vocal-cord paralysis and soon died. The second patient had a large struma; flow-volume loop improved after strumectomy. The third patient was diagnosed with extragonadal testicular carcinoma. The flow-volume loop improved after the first chemotherapy session. Flow-volume loop is an easy, non-invasive diagnostic tool that can be used even in severely-ill patients. It can provide information about the location of the obstruction and can differentiate between obstructive pulmonary disease and upper-airway obstruction. Therefore, it is recommended to obtain a flow-volume loop during the assessment of patients with upper airway obstruction.