The history should focus on establishing the diagnosis of CPO as well identifying any precipitating event. Previous episodes of CPO, orthopnoea or PND together with any historical factors that could point towards a precipitating cause should be elicited.
Table 1 lists typical historical features of patients presenting with respiratory distress to help distinguish CPO from other causes.
Symptom | CPO | COPD | Pneumonia | PE |
Precipitating Cause e.g. ACS |
SOB | ++ | + | + | + | |
Cough |
+ Pink frothy sputum |
+ Dry cough |
+ Green sputum |
Haemoptysis | |
Chest pain | + | + | + | ||
Palpitations | + | + | + | ++ | |
Fever | + | ++ | |||
Sweating | ++ | + | + | + | |
Acuity | + | + | + | ||
Nocturnal | ++ |