PT - JOURNAL ARTICLE AU - S F J Clarke AU - R J Parris AU - K Reynard TI - Core–peripheral temperature gradient as a diagnostic test in dyspnoea AID - 10.1136/emj.2004.017624 DP - 2005 Sep 01 TA - Emergency Medicine Journal PG - 633--635 VI - 22 IP - 9 4099 - http://emj.bmj.com/content/22/9/633.short 4100 - http://emj.bmj.com/content/22/9/633.full SO - Emerg Med J2005 Sep 01; 22 AB - 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.