Reason for desaturation?

[mmfd]

I am a 56 yo female (nurse) with dilated cardiomyopathy, diagnosed with an EF of 15% in 2002, and now it's 45%.  I also have mild pulmonary hypertension, supposedly secondary to the left heart failure.At that time PFT's were done with the result of restrictive lung disease.I was placed on Amiodarone for severe arrhythmias after an ICD placement failed due to left persistent superior vena cava and abnormal vasculature.  I had already known about a subclavian aneurysmal dilitation.  I immediately began to have severe sleep problems, which was found to be due to severe reflux from the Amiodarone and from frequent arousals from desaturations.  I do not have sleep apnea per se, but hypopnea, with desats much worse on my side (esp left) and best on my back, also not supporting a diagnosis of sleep apnea.  I have been on O2 at night for a year at 2 lpm with a marked improvement in sleep.  I want to know why I desat down to about 85% when I  lie down, without O2 WHILE WIDE AWAKE!  It is worse when I am on my side.  What has caused my restrictive lung disease?  My pulmonologist  says it's the heart and the cardiologist says it's from the lung. I am overweight but not morbidly obese.  My DLCO was 65%,FVC was 2.47 (77%), FEV1 74%.  Am I going to continue to need more and more O2 and eventually 24/7?  I was diagnosed with the restrictive lung disease 6 months before I went on Amiodarone.  My spiral CAT scan of the lung was essentially normal.  I run about 94% at rest but still get SOB with showering, stairs, inclines, and after meals.  I hope you have some answers for me!

[National Jewish]

Your desaturation down to 85% when you lie down could be due to a problem in the lungs such as compression atelectasis or a problem in the heart such as an anatomical right to left shunt.  The normal spiral CT scan is very reassuring, especially following the amiodarone.  This would be strong evidence against the diagnosis of pulmonary emboli.

You should first determine if you have real restrictive lung disease.  It may simply be a combination of obesity and lungs that are on the small side.  Then you should ask your cardiologist and your pulmonologist if a shunt, either intra-cardiac or intra-pulmonary could be the cause of your desaturation while wide awake.  It is too soon to predict your future oxygen needs.

[cig19335]

Oops, forgot to mention, MRI done and hemiangioma found at T-4.  Not sure if its relevant but will be speaking to neuro when he returns.

[mmfd]

Umm, does it normally take this long to get a question answered?  All questions are answered eventually, right?  I've never posted on this board.

[cig19335]

I'm in a similar situation, if you want to talk,
email me at ***@****   Remove the zeros to get my correct address.