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Dr. Andrew Rynne

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Suggest treatment for exertional dyspnea

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Dr. Arnab Maji

Pulmonologist

Practicing since :2009

Answered : 660 Questions

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Posted on Sat, 30 Aug 2014 in Lung and Chest disorders
Question: Yes, My mother is 86 and having a great deal of trouble breathing on any exertion. Sitting still she is fine. Walking slow she can only walk a few steps and she has to stop to take a few breaths. In the morning she has a cough and congested feeling upon rising for the day. She had a dbl. by pass 15 yrs. ago and has been to heart Dr. and there is nothing wrong with her heart so what would you think about her symptoms? I'm sure there's got to be something we can do. I can't believe if it were the doctors mother they'd accept the diagonosis of she's just old and her lungs just aren't going to work as good as earlier in life so there's nothing to do. I can't believe they'd let their Mom just breathe crappy for the rest of her life!
doctor
Answered by Dr. Arnab Maji 1 hour later
Brief Answer:
Kindly go through the text below

Detailed Answer:
Hello
Thanks for your query.
Exertional dyspnea in this age group may be attributed to both heart and lung disease. But as your cardiologist has already excluded heart causes then possible lung causes in this respect may be as follows -
1. Chronic obstructive pulmonary disease
2. Interstitial lung diseases
3. Pulmonary arterial hypertension
In this respect I would suggest your mother to go for the following investigations along with clinical examination by a good pulmonologist -
1. Chest X-ray (PA view)
2. Spirometry with bronchodialator reversibility testing
3. HRCT scan thorax if chest X-ray is inconclusive or non-contributory
You should visit the office of another pulmonologist and get your mother thoroughly examined.
If you want to know further you can write back to me.
If you are happy with my answer, kindly write a review for me.
Thank you.
Regards,
Dr Arnab Maji
MBBS (Hons), MD
Consultant Pulmonologist
Above answer was peer-reviewed by : Dr. Vinay Bhardwaj
doctor
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Follow up: Dr. Arnab Maji 21 hours later
Do you think it could be COPD or something to do with her thyroid? Her doctor did say something about her thyroid awhile ago but I'm not sure what as I wasn't there. Could this possibly be Asthma as my sister, my son, niece and myself all have it. She says she feels so congested upon rising could there be a build up of fluid or mucus in her lung caused by some disease?
doctor
Answered by Dr. Arnab Maji 3 hours later
Brief Answer:
COPD, late-onset asthma are strong possibilities

Detailed Answer:
Hi
Thanks for writing back.
Retrosternal goitre may cause this symptoms. Thyroid problems can cause this problem. But COPD and late-onset asthma are more compatible with the symptoms she has. Everything will be revealed by the investigations which I prescribed you in my previous answer. Go for the tests and get your mother clinically examined by a good pulmonologist. I hope you soon will get your answer.
Thank you.
Regards,
Dr Arnab Maji
MBBS (Hons), MD
Consultant Pulmonologist
Above answer was peer-reviewed by : Dr. Vinay Bhardwaj
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