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October 22, 1982

Dyspnea on Exertion: Is It the Heart or the Lungs?

Author Affiliations

From the Division of Respiratory Physiology and Medicine, Department of Medicine, Harbor-UCLA Medical Center, Torrance.

JAMA. 1982;248(16):2039-2043. doi:10.1001/jama.1982.03330160083033

DYSPNEA is a sensation, a symptom, a complaint on the part of the patient of not being able to breathe enough or having to breathe too much, or, simply, an abnormal, uncomfortable feeling during breathing. Exertional dyspnea is the most common symptom of patients with pulmonary and cardiovascular diseases and the diseases of the pulmonary circulation. Since dyspnea during exercise precedes dyspnea at rest, exercise testing can expose cardiovascular and lung disease at an earlier stage if the patient is examined during exercise.

Our understanding of the factors that cause dyspnea with exercise has greatly improved since measurement of gas exchange and ventilation during exercise has been made reliable and easy by the development of new transducers and minicomputers. Not only has insight been gained into the mechanisms of dyspnea, but we have learned how to use exercise tests to distinguish between its various clinical causes. This review describes the