Shortness of Breath

The Key is a Systematic Approach


Shortness of breath is the most common type of difficulty breathing. As people age the number of conditions which can cause this vague symptom grows considerably. Shortness of breath is one of the most distressing feelings and is hard to describe for anyone who has never felt it. Those patients who try to describe it say it’s a feeling of breathing in only half way and then trying as hard as possible to just suck in one more little bit of oxygen. It’s an exhausting feeling and leaves patients with a feeling that life is slipping away which causes anxiety and makes matters worse. 

We are often called to see SNF and ALF residents with new or worsening shortness of breath. Everyone is different. The cause of shortness of breath can be immediately obvious or it can be impossible to determine the exact problem. A systematic approach is the key and insures the right cause and early start to treatment.  Our doctors and specially trained Nurse Specialists can take care of many cases right at the bedside and help avoid hospital transfer and emergency room visits. We are even able to provide advanced 24/7 telemonitoring when needed. Other specialized testing such as EKGs and echocardiograms can also be done right at the facility. 

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Common Causes

Heart Disease Lung Disease Other Conditions
Heart failure COPD Infection
Coronary disease Asthma Neuromuscular disorders
Valvular disease  Emphysema Anxiety
Arrhythmias  Sarcoidosis Panic disorders
Pericardial disease Pneumonia Deconditioning
Diabetes Pulmonary emboli Metabolic conditions

Bedside Assessment 


  • Bedside appointments at SNF or ALF
  • Comprehensive evaluation and management services
  • Personalized care plans 
  • Documentation in facility EHR
  • Reduce exposure to flu and COVID with care at home
  • Management of acute symptoms on-site with tele monitoring and daily rounds  until better
  • Coordination with primary care and other specialists
  • On-call 24/7 specialty care coverage available

On-site Diagnostics 


  • Quick turnaround:  perform, interpret, and treat
  • Electrocardiography (EKG)
  • Echocardiography (echo)
  • Pulmonary ultrasound (can differentiate CHF from pneumonia)
  • Preliminary results immediately
  • Timely final results and clear treatment recommendations
  • Documentation of results in facility EHR

Evidence Driven Care


  • We provide care based on the best available evidence in both cardiology and geriatric medicine
  • Consideration and management of interactions of multiple chronic conditions
  • Clear opinions and recommendations
  • Review and reconciliation of cardiopulmonary medications every visit
  • Management of polypharmacy and reduction of redundancy

Continuity of Care 


  • Using advanced tele monitoring and daily rounds, we’re able to manage many acute patients who do not wish to go back to the hospital
  • We follow our patients after hospital transfer providing the best continuity of care 
  • Hospital care coordination is provided
  • Active discharge readiness and transition of care planning
  • Optimization of discharge plan and automatic enrollment in our readmission risk reduction program