When a patient is short of breath, what should you recognize first—and what changes your next decision?

In Episode 4 of The Clinical Next Step, we explore dyspnea through a cardiovascular lens: recognizing instability, assessing congestion and perfusion, and distinguishing heart failure from its dangerous mimics.

This episode focuses on the cardiovascular component of breathlessness, connecting assessment to investigation, treatment and disposition.

Topics include:

• Recognizing threatened breathing and impaired circulation.

• Using history and examination to distinguish cardiac causes from competing diagnoses.

• Understanding what ECG, chest imaging, natriuretic peptides and echocardiography can—and cannot—tell you.

• Approaching acute pulmonary edema, shock, valve em ...