Restrictive Respiratory Disease?

[Mike58]

I am a 47 year old caucasian male. I have been a lifelong smoker, and for about 9 months have been having difficulty breathing and wheezing. For the last 6 months my doctor has been having me take prednison and antibiotics, with no improvement. I also was taking albuterol. A chest x-ray showed nothing, and my PFT showed mild airway resistance, and suggested an obstructive respiratory disease in it's beginning stage. It also said I appeared to have a moderte restrictive respiratory disease. No air trapping. The PFT is FVC-80%, TLC 59%, RV 3, FRCN2 61% the diffusion was above the predicted scale. The MVV was 75%. He has referred me to a pulmonologist, and said they would probably do a lung biopsy. He told me this could be cardiac related. I am short of breath with exertion (bad). I have never worked around asbestos, although I was a firefighter for about 15 years, and back then we rarely wore a breathing apparatus. Any thoughts will be appreciated. Thank you

[National Jewish]

The forced vital capacity (FVC) of 80% is in between normal and mildly restrictive.  FVC is the maximum volume of air that can be forcefully and rapidly exhaled after a maximal inhalation.  However the total lung capacity (TLC) of 59% is a bit more convincing that the problem is restrictive lung disease.  TLC is the volume of air in the lungs at the end of a maximal inhalation.  Wheezing that comes from the lungs, rather than the throat, could be due to obstructive lung disease such as asthma, bronchiolitis, chronic bronchitis or chronic obstructive pulmonary disease (COPD).  With the symptoms that you are having, it is difficult to interpret the results of your pulmonary function tests (PFTs).

Keep in mind that the results of your PFTs and the assumption that your shortness of breath is coming from a lung problem could be misleading.  Shortness of breath can also be due to a heart problem or a blood clot in an artery of the lungs, called pulmonary embolism (PE).  The pulmonologist may want to test you for these conditions, if your lung function does not explain the degree of your shortness of breath.

[Mike58]

Sorry, I also have had a non-productive cough, and when it is cold my fingers turn white and then red which I have been told is Raynauds. Could this be related?