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Question is, please, what now? Within last year +, much

DOCTOR OF THE MONTH - Sep 2017
Sep 2017
User rating for this question
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Answered by

Pulmonologist
Practicing since : 2008
Answered : 9472 Questions
Question
Question is, please, what now?

Within last year +, much difficulty breathing with even mild exertion -- as well as winded in normal conversation. Can't seem to get a full breath ever. (Please assume not anxiety.) Negatively effects nearly every moment of the day. Not over wt. Never smoker. Bkgd: Was active/athletic until in age 40's when mold exposure at work (office) led to diagnosis of asthma. Inhalers seemed to make things tolerable, but something changed in past year or so. Went to pulmonologist -- who I think is excellent. Did breathing tests. 'Pulmonary stress test now shows restrictive component as well as cardiac component to dyspnea'. Cardiac echo stress was ordered.An internist overseeing the test said he saw changes (from prior results?) but test sent to cardiologist came back:

(The test was stopped fairly as I was winded and had apparently reached a certain BP, is my understanding):


TREADMILL SUMMARY

Total time: 00:07:31 Resting BP: 124 / 80 Peak BP: 174 / 84
Maximum HR: 145 % age-predicted: 92 METS: 8.326
Reason for stop: XXXXXXX HR

EXERCISE SUMMARY
1. EKG response to exercise: No diagnostic changes. Much baseline artefact.
2. No angina or anginal equivalent.
3. Exercise capacity was average.
4. Normal heart rate response to exercise.
5. Hypertensive blood pressure response.
6. No arrhythmias were noted.
ECHOCARDIOGRAPHIC FINDINGS
RESTING:
Normal left ventricular function at all wall segments.
Normal chamber sizes.
No significant valvular abnormalities.

Ejection fraction at rest: 68%
POST EXERCISE:
Normal augmentation of contractility of all myocardial segments.
Ejection fraction at exercise: 78%
CONCLUSIONS:

Negative stress test with low likelihood of clinically significant ischemia by
clinical, electrocardiographic, and echocardiographic wall motion scoring
criteria.

Q: Situation needs improvement. What now? Thanks.
Posted Mon, 27 Nov 2017 in Lung and Chest disorders
 
 
Answered by Dr. Kaushal Bhavsar 1 hour later
Brief Answer:
Please get PFT done.

Detailed Answer:
Thanks for your question on HealthcareMagic.
I can understand your concern.
I have gone through the reports you have attached.

No need to worry about heart diseases because your cardiac reports are normal.

In my opinion, you should get done PFT (Pulmonary Function Test) to rule out lung related diseases like bronchitis.

PFT will not only diagnose bronchitis but it will also tell you about the severity of the disease and treatment is based on severity only.

If PFT is showing obstructive defect then the possibility of bronchitis is more likely.

Please let me know if you had PFT in the past.

I will be happy to help you further.
Wish you good health.
Thanks.

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