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Core–peripheral temperature gradient as a diagnostic test in dyspnoea
  1. S F J Clarke1,
  2. R J Parris1,
  3. K Reynard2
  1. 1South Manchester University Hospital, Southmoor Road, Wythenshawe, Manchester, UK
  2. 2St James’s University Hospital, Beckett Street, Leeds, UK
  1. Correspondence to:
 Dr S Clarke
 Locum Consultant in Emergency Medicine, South Manchester University Hospital, Southmoor Road, Wythenshawe, Manchester, M23 9LT, UK;


Objectives: To evaluate whether the core–peripheral temperature gradient could be used to distinguish between cardiac and respiratory causes of dyspnoea.

Methods: In total, 50 patients were enrolled in the study, based on the following inclusion criteria: (a) a primary presenting complaint of dyspnoea; (b) age >40 years; (c) respiratory rate >20 breaths/min; (d) hypoxia. The tympanic temperature and the temperature of the nasal tip were recorded, and the patient’s discharge data and chest x ray results checked. Where there was discordance, arbitration was carried out by another researcher.

Results: Four patients were excluded, hence the final study sample was 46 patients. There was a statistically significant difference between the mean temperature gradients of the two study populations (p <0.001). A gradient of >8°C was able to rule in a cardiovascular cause (92% specificity) whereas one of <5°C could rule it out (100% sensitivity).

Conclusion: The test is safe, non-invasive and inexpensive. Although there were some limitations to the study, the test can still be commended as a useful adjunct to the emergency assessment of the acutely breathless patient.

  • Breathlessness
  • core peripheral temperature
  • dyspnoea
  • temperature gradient

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  • Competing interests: Tyco Healthcare provided a tympanic membrane thermometer and disposables for the duration of the study. No other funding was received.

  • We thank A Horrocks and R Sawyer for reviewing the chest radiographs of the patients in the study.