APS, Lung Function Tests

[Chris321]

I have Seronegative APS and they are still deciding about the SLE.  I had a Lung Function study in 2003.  I was 30 y/o at the time.  I am a life long non smoker.  At that time - this is what I was told:

FVC 90%
FEV 1 78%
PEF 88%
EEF 25-75 47%
FEV 1 / FVC 87%
FEF 50 52%
FIF 50 28%
MVV 85%
VC 86%
TGV 77%
RV 96%
TLC 90%
RV / TLC 108%
DLCO SB 91%
DLCOc SB 91%
DLCO/VA 82%
Hb 13.5 (which was a good day...normally that is 12's)

There impression at that time was there was a mild obstructive ventilatory defect and the diffusion capacity is normal.  They did not say this was asthma, nor did they prescribe inhalers.

I am becoming more & more short of breath, rescue inhalers do not work (I was given them previously for "asthma" they never worked back then either), fatigued w/ excertion and have to sleep with a couple pillows under my head.  The edema has me concerned.  My BNP came back normal yesterday.  I don't know the exact number.  My last echo was a long time ago...2003? showing a possible PFO and MVP.  I turn 34 next month.  I am not sure how much further I should be pushing this.  I looked at the numbers from 2003 and think there is more to this.  No one seems to want to repeat these tests.

Any ideas or suggestions would be appreciated.

Thanks,
Chris

[National Jewish]

Your increasing shortness of breath and fatigue with exertion seem out of proportion with the mild airway obstruction that has been measured by your pulmonary function tests (PFTs).  If this mild obstruction were due to asthma, then a rescue inhaler would help.  It is highly unlikely that your symptoms are due to a lung problem.

Your doctors should look for other causes of your symptoms.  This should include but not be limited to the heart, even though your BNP was normal.

[SUTRAQUIO]

Hi Chris321! Have you had a chest CT scan?Talk to your doctorand request that one be done.The heart and and lung function in combination so closely.A malfunction that is causing a prominent problem can sometimes be detected by checking these organ functions,one against the other.May God bless and heal you.

[Chris321]

Thank you for your advice.  Rescue inhalers do not help.  Mind you the last PFTs were done in 2003.  I have had several clotting events since then.  We know it isn't "anxiety" as anti-anxiety medications do not help either.  That is what they told me all my headaches were about until started having confirmed TIAs and lost the vision in my eye.  

I have been thinking heart.  Considering strong family CHD on both sides of the family and my elevated Lp(a).  In 2004?, they were unable to rule out a positior MI via a cardiac chemical perfusion study.  I guess the chest pain I had and the inverted t-waves weren't enough for them.  I won't go through that pain again.  They did do a cath that came back negative but it was decided that it was a problem with Cardiac Syndrome X which is connected to Antiphospholipid Antibody Syndrome.

I have asked for a new echo as my heart has been missing many more beats lately as my MVP is become more pronounced.  I have had problems with my heart 'pausing' (as the paramedic put it and I am so out of practice reading EKGs that I could tell you it was a problem just not what it was.) lately.  It was blow off as a fluke in the ER by the doctor.  (All my problems are 'flukes' until a few days later I land in ICU or CCU.)  At the time we thought it was from the Fentynal patch I was on but thinking about it right now, those "spells" really haven't gone away.  I will ask about a CT scan.  I won't hold my breath that I will get one (no pun intended).  You have to fight to get one when ruling out a PE around here.

Once again, thanks for the advice.  I will discuss this with my doctor again.