Integrated & Community Services - Breathlessness

Community Diagnostic Centre (CDC)

Following your recent GP appointment, you have been identified as having symptoms of breathlessness and have now been referred to the Community Diagnostic Centre (CDC) for further investigation.

We are a service who investigates non-specific/vague symptoms and aim to ensure that your symptoms are investigated as quickly and as thoroughly as possible.

Our team will co-ordinate all the necessary tests and ensure the process from start to finish is explained to you.

What is breathlessness?

Breathlessness, or shortness of breath, is the feeling of not being able to breathe well enough. It can vary in severity and have multiple different causes requiring involvement from various healthcare professionals.

As there is rarely a single cause of breathlessness, multiple investigations are often required to establish the best diagnosis and plan for you.

The CDC offers a one stop diagnostic journey to patients for their initial assessment. This allows most of your tests to be completed on the same day, eliminating the inconvenience of attending multiple appointments on different days.

What will happen after I have been referred?

Now that you have been triaged, it’s likely a pathway navigator will have already been in touch with you to book the required tests. You will then receive a letter, text and/or phone call to confirm your appointment.

What to expect on the day

On the day of your appointment, you should attend for your appointment/tests as discussed and confirmed in your recent communication. You should have already received a text message to confirm this date and time after your triage telephone appointment.

Please check in at the reception with your completed questionnaires to hand.

Should you experience any symptoms of infection, you MUST call ahead to the CDC on 0161 627 8100 or inform reception on arrival.

Tests and procedures

There are a range of tests we may suggest during your assessment in the CDC. At the end of the guide, there will be a list of the most common investigations carried out that you may have been referred for including procedural information and diagram.

Results

Once all your tests have been completed, your results will go back to our specialist team who will remotely review, interpret, and determine the best care plan for you.

If no further investigation is required, you will receive a working diagnosis. A treatment plan will be developed, and you will be sent back to GP for further management.

Management may include breathlessness self-management, smoking cessation, healthy lifestyle support including maintaining activity and weight management.

However, if further testing is required, we will contact you to schedule an appointment for any tests as required by our specialist team.

Once assessed, depending on your results if no further investigations are required you will be discharged back to your GP with a treatment plan and guidance or you may be referred into appropriate services for further treatment/specialist care.

Tests available at the CDC

Echocardiogram

An echocardiogram (or echo) uses high frequency sound waves (ultrasound) to scan the heart.

What do we look for in this investigation?

The echo scan gives information about:

The structure of the heart – showing how the different parts of the heart are connected.
The function of the heart - to see how well the muscle is pumping.
The heart valves - to show if they are narrowed or leaking.

What will happen during the investigation?

You will be asked to lie on your left-hand side, some gel will be applied to your chest and a small probe moved over the area. The probe transmits ultrasound waves towards your heart and the returning sound waves create a moving picture on the screen.
The room will be dimly lit, as this makes the pictures easier to see. Images are taken from different positions to look at your heart from different angles. You may hear some noises during the test, which gives information about the blood flow through your heart. It can take up to 45 minutes to complete the investigation, but this depends on the complexity of the test requested by your doctor.

Pulmonary Function Test (PFT)

A Pulmonary Function Test, also known as a lung function test, is a series of breathing tests that measure how well your lungs work.

The test will measure the volume and speed of the air you can blow out from your lungs. It will give an indication of the capacity of your lungs and how clear your airways are.

What will happen during the investigation?

You will be given a nose peg to seal your nose when completing this test.

You will need to breathe normally on the mouthpiece and then you will be instructed to blow out until you are completely empty.

Then you need to take a deep breath in and hold your breath for approximately nine seconds before blowing all the way out.

This test will be performed a maximum of five times, but you will have a break in between each trial.

This test usually takes 30-40 minutes to complete.

How to prepare for test

AVOID

• Smoking 24 hours before test
• Tight fitting clothes
• Large meal/fizzy drink right before test

DO
•    Wear loose clothing

Fractional exhaled Nitric Oxide Test (FeNO)

Fractional exhaled Nitric Oxide Test (FeNO) is a test to measure your breath and the level of inflammation in your airways. The test will look at how much nitric oxide you are exhaling.

What will happen during the investigation?

You will be asked to take a big breath in and then gently breathe out through the mouthpiece into a small portable device for 10 seconds. The device will show a reading on the screen. The test usually takes up around 5 minutes to complete.

How to prepare for the test

AVOID

• Physical exertion at least 1 hour prior to your appointment
• Smoking 1 hour before your test
• Hot drinks, caffeine, and alcohol at least 1 hour before your test
• Nitrate rich foods i.e. green leafy vegetables, leek, beetroot, lettuce spinach 3 hours before test.

DO

• Take medication as normal – Ensure clinician is aware of any medication taken beforehand or any activities above that have taken place.

Electrocardiogram (ECG)

An electrocardiogram or ECG is a simple test which records the rhythm and electrical activity of your heart.

What will happen during the investigation?

You will be invited into a clinical room where you will be asked to undress to your waist. You will be offered a dignity gown.

You will be asked to lie on an examination couch and will have sticky pads called electrodes placed on your chest, arms and legs. It would be a good idea to wear something that would allow easy access to the bottom of your legs.

The physiologist will connect you to the ECG recorder by clipping leads onto the electrodes. You will be asked to relax and keep as still as possible whilst a recording is taken. The test usually takes up to 10 minutes to complete.

How to prepare for my test?

Please do not use any body lotions or creams before your test.

Contact Details

Please contact for further advice via email at Maymona.rahman@nca.nhs.uk or Dionne.johnson@nca.nhs.uk

You can write to us at: Northern Care Alliance NHS Foundation Trust, Oldham Community Diagnostic Centre, Salmon Fields, Royton, Oldham, OL2 6JG.

You can call us if you need more advice on 0161 627 8105.