Acute Medicine | Breathlessness 18 knowledge B for GPs

Anaemia and Breathlessness
Session Overview
Description
This session describes how to evaluate, investigate and plan the management of a patient presenting with breathlessness due to anaemia.

Learning Objectives
By the end of this session you will be able to:

• Describe the evaluation of a patient presenting with anaemia and breathlessness
• Describe how to investigate a patient presenting with breathlessness and anaemia
• Plan the acute management of a patient presenting with breathlessness and anaemia

The World Health Organisation defines anaemia as a haemoglobin (Hb) level below 12g/dL in women or 13g/dL in men; although local ranges may vary.

Anaemia may be the sole cause of breathlessness in some patients or may precipitate or worsen breathlessness in patients with pre-existing cardiorespiratory disease.

The degree of breathlessness due to anaemia in an individual patient is dependent on many factors, including the cause of the anaemia, speed of onset, age and co-morbidities of the patient.

As the diagram shows, it is important to remember that not all anaemic patients will be breathless because of their anaemia. If the history of the anaemia does not fit, other causes of breathlessness need to be sought.

This session deals with the acute investigation and management of a patient with breathlessness due to anaemia. Several anaemia classifications can aid the investigation of the patient presenting with SOB and anaemia, however the most useful in clinical management is that based on the red cell indices.