My husband has had several years now of tests and no answers. He is not a hypocondriac and rarely complains but has been going though so much pain and discomfort. He has diminished lung capacity, difficulty breathing, pain in his right side, chest pain ,frequent heart palpitations and no stamina with any physical exertion. He has had his heart checked, his lungs and almost everything else. The doctor finally told him to get on an antidepressant (which did nothing). At one point they said he had a paralyzed diaphram (now it appears he does not). The pain continues. It used to be he would go though a few months with some relief but now maybe has it eases up for a few weeks only. His blood work looks ok except a d-dimmer titer was over 1000. He went to a rheumotologist and he said it was not sclerderma (thank God!). He doesn't even know where to go from here to be tested. We live in Michigan, near Detroit. Any ideas of other areas to be tested? He is a foot doctor. At one point he was tested for nail fungus and it appeared he was alergic to that. He has stopped grinding nails and wears a mask and gloves. Still the difficulty breathing. Please help.
I would suggest a referral to a pulmonologist. Many things can elevate a d-dimer, but one thing I would make sure is a chronic pulmonary embolus. A CT pulmonary angiogram or ventilation/perfusion scan would be reasonable tests to evaluate for this.
A CT scan, including high-resolution CT scan, should be performed, in addition to pulmonary function tests - if they haven't been performed already.
A more specialized test would be cardiopulmonary exercise testing. Cardiopulmonary exercise testing is indicated when the etiology of a patient's shortness of breath remains unclear after the initial evaluation described above, or when it seems out of proportion to the severity of the patient's known cardiac or pulmonary disease. This test can determine whether the shortness of breath is coming from the heart or lungs.
Another heart test would be a blood test known as a B-naturetic peptide. Elevated levels of this would suggest a cardiac source.
In any case, I would suggest a referral to a pulmonologist to discuss the possibility of these tests. Any academic medical center (i.e. near a major city like Detroid) would be appropriate.
Followup with your personal physician is essential.
This answer is not intended as and does not substitute for medical advice - the information presented is for patient education only. Please see your personal physician for further evaluation of your individual case.
The Content on this Site is presented in a summary fashion, and is intended to be used for educational and entertainment purposes only. It is not intended to be and should not be interpreted as medical advice or a diagnosis of any health or fitness problem, condition or disease; or a recommendation for a specific test, doctor, care provider, procedure, treatment plan, product, or course of action. MedHelp is not a medical or healthcare provider and your use of this Site does not create a doctor / patient relationship. We disclaim all responsibility for the professional qualifications and licensing of, and services provided by, any physician or other health providers posting on or otherwise referred to on this Site and/or any Third Party Site. Never disregard the medical advice of your physician or health professional, or delay in seeking such advice, because of something you read on this Site. We offer this Site AS IS and without any warranties. By using this Site you agree to the following Terms and Conditions. If you think you may have a medical emergency, call your physician or 911 immediately.