"Hello, I’m [Your Name], one of the doctors/nurses. I understand you've come in today because you've been experiencing shortness of breath. Is that right?"
"Before we go any further, what are your thoughts about what might be causing this breathlessness, or what it might mean?"
"And is there anything in particular that you're worried about, or anything you were hoping we could achieve during our conversation today?"
"Could you describe your shortness of breath for me? When did it first start, and did it come on suddenly or gradually?"
"Does it happen when you're exerting yourself, like walking up stairs, or even when you're at rest?"
"How would you describe the feeling of breathlessness? Is it a tightness in your chest, a heaviness, or do you feel like you're gasping for air and can't get enough?"
"Have you noticed any other symptoms happening with the breathlessness? Like a cough, wheezing, or chest pain? What about palpitations, swelling in your legs, fever, chills, night sweats, or unexplained weight loss?"
"How has the breathlessness changed over time? Is it constant, or does it come and go? Is it worse at certain times of the day, or do you wake up breathless at night (paroxysmal nocturnal dyspnoea) or get breathless when lying flat (orthopnoea)?"
"What makes the breathlessness better or worse? For example, does rest help, or do certain positions improve it? Do your inhalers help, if you use them? Does it get worse with activity or exposure to certain things like cold air or allergens?"
"On a scale of 1 to 10, how severe is this breathlessness, and how has it been affecting your daily life? For example, how many flights of stairs can you climb, or how far can you walk before you get breathless?"
"I also need to ask about some important 'red flag' symptoms. Did the breathlessness start very suddenly and severely? Is it associated with chest pain, coughing up blood, or fainting? Have you had any significant weight loss or fevers? What about swelling in just one leg, which could indicate a clot?"
"Do you have any existing medical conditions, such as asthma, COPD (emphysema or chronic bronchitis), heart failure, coronary artery disease, anaemia, kidney disease, or thyroid problems? Do you have any known allergies?"
"Have you ever had any operations or procedures, especially any lung or heart surgery?"
"Are you currently taking any medications, including anything prescribed by a doctor, or any over-the-counter medicines, supplements, or herbal remedies? This includes any inhalers you might be using, or any medications for your heart. Some medications can also cause lung side effects, like amiodarone or methotrexate."
"Do you have any allergies to medications or anything else? If so, what kind of reaction did you have?"
"Does anyone in your close family – like your parents, siblings, or children – have a history of lung conditions like asthma, COPD, or cystic fibrosis? What about heart disease, blood clots (like DVT or PE), autoimmune diseases, or cancers?"
"Could you tell me a little about your living situation and who you live with? Do you have a good support network around you? Are you able to manage all your daily activities? What kind of work do you do, and have you been exposed to any dust, chemicals, or hazardous substances like asbestos at work, either now or in the past?"
"Do you smoke, and if so, how much and for how long? Have you been exposed to passive smoke?"
"How much alcohol do you drink in a week? Do you use any recreational drugs?"
"Have you recently travelled anywhere, especially long-haul flights, or been exposed to anyone with an infectious disease like tuberculosis?"
"Thank you very much for sharing all of that information with me. Just to summarise, you've been experiencing [recap key symptoms], which started [onset] and are often [character/timing]. This has been impacting your [daily life areas]. You've also mentioned [recap relevant PMH/DH/FH/SH]."
"Does that sound like an accurate summary? Is there anything else you feel is important that we haven't covered?"
"Based on what you've told me, the next steps would be for me to perform a physical examination of your chest and heart, and then we would likely arrange for some investigations, such as a chest X-ray, an ECG (heart tracing), blood tests, or lung function tests. Depending on the findings, we might also consider a CT scan."
"Do you have any questions for me at this stage?"
"Thank you for your time."