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hypoxia on exertion - no dx
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hypoxia on exertion - no dx

my wife - 46 year old non smoker (never in her life) apr 120 pounds, 5ft6in
Physically active (prior to condition, would do cardio work out 3 times a week and walk 20 minutes 3 times a week)

Primary complaints were chest pain, shortness of breath

Began to see symptoms everytime she was doing more than sitting.

went to GenPrac, who discovered ox sats drop on mild exertion. (used finger pulse ox)
at rest, 99% SpO2
walking, within 30 seconds, ox sats dropped to mid-high 70% range, and dyspnea/chest pain would begin.

At rest, within 2 minutes, full recovery, 99% SpO2, very mild remaining pain in chest, no dyspnea

GenPrac ordered PFT,CBC,ChestXray, CT with without contrast, ekg, ecg, overnight PulseOx
Wife struggled a little with PFT, but results seem acceptable for height/weight
CBC looked good, thyroid slightly elevated...
ChestX transcription notes small amount of scarring in upper apex of right and left lung, but reading radiologist noted no concern.
CT/CTA was fine.
EKG fine
ECG looked good
Overnight Ox fine, 0 events, full time recording (no apnea)


Doc ordered supplemental O2 at home, 2 liters, to be used when not at rest.
With or without O2, symptoms appeared.

about 6 months ago saw a 5 day stay in Hospital (elevated chest pains and shortness of breath, symptoms similar to heart attack)
While in hospital
Potassium level slightly elevated on admit, but fine rest of the stay
Saw a few episodes of low SpO2 on initial admit, but cleared up, not reproducable during rest of stay
another chestx - fine
1 minute ekgs were fine
Trans-Esophegial-echo - fine (Cardiologist was looking for any leaky heart valves)
ct/cta looked fine
Myriads of blood work, including rhumatiod,CBC,ABG, (dont remember the rest) all within clinical norms, including potassium

Discharged with no diagnosis

after hospital stay, Followed up on elevated thyroid with a full tsh,t4,t3 blood work, all normal

We ordered a fingerPulseOx, with apr 2% accuracy rating (non certified) and can watch SpO2 levels rise and fall with exertion

We have attempted to rule out envronmental concerns, such as asbestos, molds, etc...including going as far as moving into apartment, and she has not been back to work since initial doctors visit, apr. 8 months ago.

All items from house are in storage, not brought into apt.

upon moving out of house, and not working, symptoms improved for a time, but have now returned.
We were shopping a few days ago, and she could not walk across the store isle. She had to sit down and rest.

apr 1 month ago she went to alergist, who did skin tests, saw no elevated reactions.
Alergist was able to reproduce same results on a fingerPulseOx
Alergist ordered a fungal Serology panel, all results came back within clinical norms.

She goes to a polmunologist in 1 week, to see if he has additional ideas...

Any additional ideas from here?
2 Comments Post a Comment
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Avatar_n_tn
I have fibrosising mediastnitis stenosis caused by the spores in the ground from chicken , here in Ohio alot of people have histoplasmosis which can lead to my disease only detected on a high resoulution CT scan and a cardiac MRI . Have any questions let me know . Felicia
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Avatar_m_tn
I am having a hard time finding any sort of concrete information on  fibrosising mediastnitis.
I have read up a little, and have a general idea, but not real clear, and can't seem to find symptoms...

would you say symptomatically, that you experience/d the similar things that my wife is going through?

She just visited the genprac again... she dropped to low 60%...
but to very little avail... basically, he blames her environment, even though she has been removed from all environmental concerns for almost a year....

Thanks,
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