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Respiratory Disorders (Expert Forum)
Asthma, Emphysema, COPD, etc?
Answered by
This forum is for questions and support regarding lung and respiratory issues such as: Allergies, Asthma, Bronchitis, Colds - Flu, Chronic Cough, COPD, Cystic Fibrosis, Emphysema, Fibrosis, Lung Abscess, Nasal Polyps, Pleurisy, Pneumonia, Sarcoidosis, Sinusitis, Tuberculosis.
Asthma, Emphysema, COPD, etc?
by DJBinks, Feb 18, 2004 12:00AM
Hi,
I'm a 29 yr old male, caucasian, 225 lbs, and fairly athletic. Over the last 3 months I've been experiencing dyspnea (chest/throat feels tight) on daily / near daily basis. For about ten years I've smoke marijuana on-and off (sometimes frequently and other times going months without smoking it).
My doctor ordered a series of PFT tests and the results are shown below. What do you make of them...Is it emphysema, asthma, etc?
Ref Pre Pre Post Post Post
Meas % Ref Meas % Ref % Chg
-----------------------------------------------------------------------
FVC Liters 5.84 6.48 111 6.33 108 -2
FEV1 Liters 4.53 4.46 99 4.83 107 8
FEV1/FVC % 77 69 76
FEF25-75 L/sec 4.64 3.12 67 3.99 86 28
PEF L/sec 10.42 11.03 106 11.98 115 9
FIVC Liters 5.84 6.05 104 6.05 104 0
FEF50% L/sec 6.05 3.99 66 4.16 69 4
FEF75% L/sec 2.59 1.43 55 1.83 71 28
MVV L/min 190
SpO2 98%
Pulse 83/Min
Thank You very much for your time and expertise.
I'm a 29 yr old male, caucasian, 225 lbs, and fairly athletic. Over the last 3 months I've been experiencing dyspnea (chest/throat feels tight) on daily / near daily basis. For about ten years I've smoke marijuana on-and off (sometimes frequently and other times going months without smoking it).
My doctor ordered a series of PFT tests and the results are shown below. What do you make of them...Is it emphysema, asthma, etc?
Ref Pre Pre Post Post Post
Meas % Ref Meas % Ref % Chg
-----------------------------------------------------------------------
FVC Liters 5.84 6.48 111 6.33 108 -2
FEV1 Liters 4.53 4.46 99 4.83 107 8
FEV1/FVC % 77 69 76
FEF25-75 L/sec 4.64 3.12 67 3.99 86 28
PEF L/sec 10.42 11.03 106 11.98 115 9
FIVC Liters 5.84 6.05 104 6.05 104 0
FEF50% L/sec 6.05 3.99 66 4.16 69 4
FEF75% L/sec 2.59 1.43 55 1.83 71 28
MVV L/min 190
SpO2 98%
Pulse 83/Min
Thank You very much for your time and expertise.
Doctor's Answer
by National Jewish, Feb 19, 2004 12:00AM
, Feb 19, 2004 12:00AM
Your pulmonary function tests (PFTs) show some small airway obstruction. However this is not enough to cause your shortness of breath. If you are short of breath only when you exercise, it could be exercise-induced asthma. Also if you have recently gained a lot of weight, this could explain your shortness of breath. Another possibility that you should be checked for is pulmonary emboli (PE). This is a blood clot in an artery of the lung, which can certainly cause shortness of breath. PE can be found with a CT scan of the chest or VQ lung scan.
Since your throat feels tight, vocal cord dysfunction (VCD) is also a possibility. This is a condition that can mimic asthma. However, VCD is not helped by asthma medicines. While inhaling the vocal cords should open to let air into the lungs. With VCD the vocal cords close together during inhalation. This makes it difficult for air to get into the lungs. A lot of the same things that trigger asthma can trigger VCD including upper respiratory infections, fumes, odors, cigarette smoke, singing, emotional upset, post-nasal drip and exercise. Sometimes the trigger is not known. Testing needs to be done while you are having symptoms. Breathing tests may be normal, but the “breathing in” or inspiratory part, also called an inspiratory flow volume loop, will show little airflow while you are inhaling. A laryngoscopy is a procedure done by a specialized doctor using a camera at the end of a flexible tube to see how your vocal cords open and close. VCD is treated by a speech therapist that will instruct you in open throat breathing techniques. Counseling can help you identify and deal positively with chronic stress, which may be an underlying factor in VCD. Please read our Vocal Cord Dysfunction MedFact at http://www.nationaljewish.org/medfacts/vocal.html for more information. It is important for you to be evaluated by a doctor to determine the diagnosis and appropriate treatment.
Since your throat feels tight, vocal cord dysfunction (VCD) is also a possibility. This is a condition that can mimic asthma. However, VCD is not helped by asthma medicines. While inhaling the vocal cords should open to let air into the lungs. With VCD the vocal cords close together during inhalation. This makes it difficult for air to get into the lungs. A lot of the same things that trigger asthma can trigger VCD including upper respiratory infections, fumes, odors, cigarette smoke, singing, emotional upset, post-nasal drip and exercise. Sometimes the trigger is not known. Testing needs to be done while you are having symptoms. Breathing tests may be normal, but the “breathing in” or inspiratory part, also called an inspiratory flow volume loop, will show little airflow while you are inhaling. A laryngoscopy is a procedure done by a specialized doctor using a camera at the end of a flexible tube to see how your vocal cords open and close. VCD is treated by a speech therapist that will instruct you in open throat breathing techniques. Counseling can help you identify and deal positively with chronic stress, which may be an underlying factor in VCD. Please read our Vocal Cord Dysfunction MedFact at http://www.nationaljewish.org/medfacts/vocal.html for more information. It is important for you to be evaluated by a doctor to determine the diagnosis and appropriate treatment.
