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Have had viral pneumonia, reynaud's syndrome and sjogren's syndrome. What is your prognosis?

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General & Family Physician
Practicing since : 1978
Answered : 6593 Questions
I am a 70 year old woman. Three years ago I was hospitalized with viral pneumonia. My condition was considered terminal. I had a trach which had to be repaired after three years since it did not close naturally.

It took three years of hospitalization, rehab, and PT for me to learn to breathe on my own; handle my own needs (bathroom, feeding, talking, sitting, walking, etc). I need surgery on my toes, which are crossed to aid my balance and walking.

I was diagnosed with PMV in my twenties and have had no serious problems with it. I also have RA, Reynaud's syndrome, and Sjogren's syndrome.

I have been taking pre-operative tests for foot sugery. All tests have been normal except the ECG. I am scheduled for a chemical stress test for reversible ischemia.

What is your prognosis?

Thank you,
Posted Wed, 10 Oct 2012 in General Health
Answered by Dr. Pavan Kumar Gupta 8 hours later
Thanks for the query.
In addition to joints, the autoimmune process of RA can also affect the eyes, lungs, skin, heart and blood vessels, and other organs, including the heart and lungs not to mention the side effects of medications taken for the RA,which can take it's toll on different systems of body.

Systemic inflammation puts people with RA at increased risk of cardiovascular disease. Recent research shows that people with RA have an increased risk of heart attack that is about the same as for people with type 2 diabetes. Having RA also increases risk of stroke. 

Swelling and inflammation of the outer lining of the heart (pericarditis) and of the heart muscle (myocarditis). Both of these conditions can lead to congestive heart failure.
In light of your abnormal ECG and considering your rheumatoid arthritis and age,chances of abnormal stress test are very high.

I hope to have answered your query however if you have any additional concern,I would be happy to address it.
Best of luck
Above answer was peer-reviewed by
Follow-up: Have had viral pneumonia, reynaud's syndrome and sjogren's syndrome. What is your prognosis? 14 hours later
I don't feel you have answered my question.

I know the chances of an abnormal stress test are very high. Do you feel I am at serious risk of heart failure?

I know the chemical stress test has a 50% chance of being a false positive. Do you think I will need a cardiac catherization or a mitral valve replacement?

Thank you,
Answered by Dr. Pavan Kumar Gupta 30 minutes later
You are definitely at increased risk of heart failure.
As far as cardiac catheterization or like echocardiography or coronary angiography.
Above answer was peer-reviewed by
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