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Kortademigheid: is het pulmonaal of cardiaal, of beide?

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Bijblijven

Samenvatting

Kortademigheid (dyspneu) is een frequent voorkomende klacht in de huisartspraktijk en leidt tot diagnostische problemen bij patiënten die ouder zijn dan 65 jaar. Differentiatie tussencopd en hartfalen is moeilijk, terwijl beide aandoeningen vaak gezamenlijk voorkomen, mede door gemeenschappelijke etiologische factoren; roken, atherosclerose en inflammatie. Zo blijkt onbekend hartfalen frequent (1:5) voor te komen bij patiënten die 65-plus zijn en bij wie de huisarts een chronische obstructieve longziekte (copd) gediagnosticeerd heeft.

In deze bijdrage wordt ingegaan op het ontstaan van de sensatie van kortademigheid. Verder worden de belangrijkste diagnostische items uit de anamnese (met voorgeschiedenis) en het lichamelijk onderzoek voor de meest voorkomende oorzaken van dyspneu besproken. Chronische dyspneu bij patiënten van 65 jaar en ouder wordt uitgebreid behandeld, met speciale aandacht voor het diagnosticeren van hartfalen bij patiënten met de huisartsdiagnosecopd.

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    F.H. Rutten

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  1. F.H. Rutten
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Dr. F.H. Rutten, parttime huisarts en parttime verbonden aan het Julius Centrum voor Gezondheidswetenschappen en Eerstelijns Geneeskunde, Universitair Medisch Centrum Utrecht.

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Rutten, F. Kortademigheid: is het pulmonaal of cardiaal, of beide?. BIJB 22, 114–120 (2006). https://doi.org/10.1007/BF03059921

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