nonpulmonary

Nonpulmonary refers to diseases, conditions, or symptoms that do not originate in the lungs or pulmonary vasculature. In medicine, the term is used to distinguish processes outside the respiratory system from primary pulmonary disease, which includes disorders of the airways, parenchyma, and pulmonary circulation.

Nonpulmonary etiologies for dyspnea and related symptoms span multiple organ systems. Cardiac causes such as heart failure and ischemia; hematologic causes such as anemia; metabolic disturbances including severe acidosis or electrolyte abnormalities; neuromuscular and chest wall disorders affecting respiratory mechanics; obesity hypoventilation syndrome; deconditioning; and psychological factors like anxiety or panic disorders.

Assessment emphasizes ruling out pulmonary disease while identifying nonpulmonary contributors. Evaluation commonly includes history, physical examination, chest imaging to assess lungs, echocardiography or cardiac testing for cardiac etiologies, laboratory studies (hemoglobin, arterial blood gas), and targeted pulmonary function tests when indicated. Treatment targets the underlying nonpulmonary condition and may involve specialists such as cardiology, hematology, endocrinology, neurology, or rehabilitation.

The distinction between pulmonary and nonpulmonary is practical but imperfect; many conditions involve both pulmonary and nonpulmonary processes. Clinicians integrate clinical findings, imaging, and laboratory data to determine the dominant driver of symptoms and tailor management accordingly. Nonpulmonary considerations are routinely included in differential diagnoses for presentations such as dyspnea, chest pain, fatigue, or syncope.