Breathlessness” or “dyspnoea”. The discussion regarding this has already been described in detail in the Perspective piece [1]. The consensus relates to the internationally recognised name of the syndrome in English. The consensus was that the term should be that used by the lay public rather than healthcare professionals. Professionals will understand both, whereas the lay public may not understand “dyspnoea”, as one of the aims of a syndrome is to empower patients and their families to bring this concern to clinical notice. At least in English, “breathlessness” and “dyspnoea” are not interchangeable. For there to be a cultural and linguistic translation to languages other than English, it should be a term used by their lay public. “Optimal treatment”. After much discussion during the consensus process and workshop, the term “optimal” used in the Perspective referred to the available, tolerated and patient-accepted evidence-based intervention(s) targeting the primary pathophysiological processes of the underlying disease [1]. This is not sufficiently clear in the Perspective piece, although touched on in table S1 [1]. There is no intention that patients should be deprived of interventions targeted at the symptomatic management of their breathlessness because they do not tolerate, refuse or cannot access state of the art treatment for their medical condition. On the contrary, one of the aims of defining such a clinical syndrome is to draw attention to the available breathlessness-targeted treatments. These should be used systematically alongside disease-directed treatments both whilst disease treatments are being optimised and thereafter. This also mandates the review of how breathlessness is being managed regularly in order to gain the best possible outcomes for patients and their families. For people with chronic breathlessness syndrome, attention to the need for and use of breathlessness-targeted treatment will still be reviewed regularly with each clinical encounter.