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A Journal on Forensic Medicine
Minerva Medicolegale 2002 June;122(2): 65-72
Dyspnea. Clinical criteria, medicolegal evaluation and a new proposal
Dyspnea is a subjective symptom represented by the sensation of difficulty in breathing and it is easily influenced by an increase of the ventilatory effort and by individual and psychological factors. It's a symptom caused by various pulmonary diseases, but even by cardiovascular, metabolic, hematologic disorders or psychological factors. That's why it's necessary to evaluate it by medical history, physical examination, laboratory tests, chest radiography, spirometry and so on. Considering its subjective characteristic, only pulmonary-function tests are not enough to measure dyspnoea, but it's possible to use evaluation scales, including even daily activities. The most used scales and indexes are: the model proposed by the MRC, VAS, CRQ, SGRQ, BPQ and BDI. This way, it's possible to evaluate better the real quality of life in patients with chronic lung diseases, considering that psychological and social factors are essential, because they influence the magnitude of dyspnea under the same responsible pathology. A new proposal has been suggested, collecting pulmonary function tests, MRC and BDI scores and exercise testing.