Shortness of Breath, Fatigue and Chest Discomfort

[Deneen]

I have been having the above symtoms since November and are gradually getting worse....  Echocardigram came back fine, stress test was also fine, on the blood work I have a high alk phos. CL and PROBNP.  Last CT reads, Subcentimeter subpleural nodular density right upper lobe.  This is stable Ill-defined nodule right upper lobe.  This measures approximately 3 to 4 mm. On 2 prior studies this measured approx 3mm.  Previously noted nodules in the posterior right lower lobe are not as well seen due to atelectatic change.  Again noted is subcentimeter subpleural nodular density in the posterior medial left lower lobe similar to prior study.  Bibasilar atelectatic change.  No plueural effusions.  Thoracic aorta is normal in caliber.  Atherosclerotic disease. No intimal flap identified.  No central pulmonary embolus identified.  Mild stranding of the anterior mediastinal mesenter.  Occassional subcentimeter axillary and mediastinal lymph nodes.  Subcentimeter right hilar lymph node.  There appears to be calification within the thyroid gland bilaterally.  Any thoughts on these results?

[National Jewish]

At least, on the basis of size and stability, these nodules are probably of no consequence and unrelated to your symptoms.  During your stress test if you exercised to 85% or more of predicted along with your normal echocardiogram, a heart problem is probably not the cause of your shortness of breath.

Asthma is another possible cause of your shortness of breath.  Generally testing for asthma starts with a simple breathing test called spirometry.  This test provides detailed information about how your lungs are working.  It will show if there is obstruction in your airways.  To really test for asthma this test may be repeated after using a rescue inhaler, like the bronchodilator albuterol that you are using.  This measures how much the bronchodilator helps your lungs by reversing the problem.  When there is a 20% increase the test is positive for asthma.  However it is possible for this test to be normal when a person with asthma is not having breathing difficulty.

[Faith3116]

A related discussion, Heart or not was started.

[myproblem]

This could be early signs of emphysema. Quit now while you can still breathe on your own. The damage won't reverse itself, but you will prolong your life, and sustain your quality of life too.

[Deneen]

Also had a PFT test that reads.  This 41 year old female has been smoking a pack a day for the last 22 years.  Diffusion capacity is minimally reduced at 71% of predicted and when corrected for loss of functioning alveolar volume, it is recorded at 64% of predicted.  When compared to 2004, the diffusion study has fallen from 80% of predicted.  A low diffusion study with normal spirometry may be seen in patients with pulmonary emboli, pulmonary fibrosis, pheripheral vascular disease or pulmonary artery hypertension.