ASTHMA OR COPD?

[soxfan]

Hi.  I recently underwent a Methacholine Challenge Test for symptoms of cough, shortness of breath, difficulty breathing especially at night, etc.  My dad had COPD and congestive heart failure.  I was recently diagnosed with congestive heart failure also.  My pulmonologist (before getting the test results) put me on Singular and Advair but they haven't seemed to help much yet.  I have the results of the test and it says:

This test is negative for reactive airway disease as seen by maximum
of
    12% drop in FEV1 at an exposure of 12.5 milligrams per ml of
    methacholine, however peak expiratory flow did drop to 24% at the
    maximum level of methacholine exposure with the patient having chest
    tightness and this resolved to normal after bronchodilator, hence
    clinical correlation is advised with regard to further treatment.  If
    the patient has symptoms suggestive of reactive airway disease
    clinically then the patient can be given an empiric trial of
    anti-inflammatory treatment along with bronchodilators.

Is this positive for asthma or could it be COPD?

Thanks!

[National Jewish]

Using well-accepted, standard criteria, these results are negative for asthma.  The drop in peak expiratory flow does not change that interpretation.  Your cough, shortness of breath, and difficulty breathing especially at night could all be due to heart failure.

With your family history, you could have COPD, especially if you smoked cigarettes for years.  The best way to find out if you have COPD is with pulmonary function tests (PFTs), not a methacholine challenge test.  Singulair® (montelukast sodium) does not help COPD.  Not all people with COPD benefit from Advair™ Diskus® (fluticasone/salmeterol).

[EROS]

If you have the report it might be a good idea to post your FEV1, FVC, and FEV1 / FVC values. And DCLO (sometimes called TCLO) if the test was done.

This will give the NJ more info to answer you.

[EROS]

By the way strictly FEV1 needs to drop 20% in asthma but this test is not foolproof. Your symptoms may improve after albuterol but your PFT results might not!