A very active, healthy 83 year old woman, has sudden onset angina, subsequent triple CABG, easy recovery, then a month later has a pulmonary embolism. This was resolved with usual therapy, and continuing coumadin. She began to resume her usual activities of swimming for 45 minutes a day 5-6 days a week and walking 45 mnutes a day when chest pain, both at rest and with any activity recurred, associated with acute dyspnea. Symptoms somewhat more prevalant mid morning requiring cessation of most activity. Followup cardiac myoview stress test nondiagnostic, and subsquent heart recatheterization demonstrates patent bypasses and no new areas of concern.
Pulmonary function test report pending, but reportedly patient was unable to adequately perform FEV testing...and was short of breath and had increased chest pain for 12-24 hours post PFT.
Is this a form of COPD, pulmonary fibrosis or ? post PE? What is treatment?
I honestly don't know. It's baffling, because I was almost leaning more towards the heart as an issue. Generally when there are issues of the lungs, the person would experience more shortness of breath during physical activity. COPD would include chronic cough with mucous production and 90% of the cases are due to smokers. And pulmonary fibrosis is essentially lung scarring due to continuous exposure to certain environmental substances. Also a dry cough is present with shortness of breath particularly on exertion and chest discomfort. Basically the only way to really diagnose a lung issue is through pulmonary function tests. But to get any conclusive data from the tests the patient needs to perform consistently The only lung disease that has reversibility in reduced lung function is asthma. The rest are permanent lung function losses. Sometimes the diaphragm doesn't perform properly and thus not allowing the patient to breath properly. She will have to see a pulmonary specialist to determine what is going on in the lungs.
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