Is othopnea common with non-cardiac asthma?

[LowMac]

Hi,

I've posted in other forums, this is my first in the asthma one.

First, in regard to my question: "Is Orthopnea common with non-cardiac asthma?" (more difficulty breathing, lying flat on one's back - supine position, with regular asthma)

I'm not asking this to substitute a diagnosis. I'm actually seeing a doctor regularly under my BlueCross BlueShield coverage and also awaiting a review on a chest exray.

I have no heart symptoms (i.e. no pain, no swelling in extremeties etc...), in fact had a normal EKG/Stress test in year-2001.

My asthma symptoms manifested mildly for years and then at my current age-47, began to worsen but still is only moderate (no severe attacks). I've become a bit obese in my middle age - 20 to 30 lbs (i'm 6ft, 235 lbs) , which I believe to have worsened the asthma. I am treated for hypothyroidism that was diagnosed at the mild stage, caused by Hashimoto's thyroiditis. Despite this, I've had ongoing symptoms similar to CFS and fibromyalgia (more-so CFS). I was also recently found to be vitamin D deficient (flagged low) and being treated for it, plus mildly B12 insufficient (lower normal) and being treated for it as well.

While the most obvious answer is that my asthma is due to my compromised immune system and is the common garden variety, my finding of med-sources that describe cardiac asthma caused me some anxiety, the main description on these sources being that of cardiac asthma (congestive heart failure).

Really the only similarity I found was that of breathing difficulty when lying flat on my back. I otherwise do not have fluid build-up in my lungs and I don't have foamy urine or sputnim. I also do not have swelling in my feet or ankles (no pitting edema). My blood pressure is normal, although borderline at times and I don't experience palpitations or arrhythmias.

What I did find hard to locate, are med sources simply saying that orthopnea was common with regular asthma.
While I welcome comments on the rest of my post, my main question I ask for your input-on is this (many of you may can answer this from your personal experience):

"Is Orthopnea common with non-cardiac asthma?" (Thanks much folks!)

[LowMac]

I appreciate the comment. I agree, not only would fluid in the lungs be a serious problem, rather than the sticky mucous that occurs with regular asthma but many other unmistakable signs occur with CHF, including swelling of the extremeties, angina and serious heart arrhythmias.

Of course early onset, milder cases might present with milder degrees of these and is why I had the tests ran to rule it out. That BNP test is quit a breakthrough because it has a 98% negative accuracy and those levels that are questionable in the small 2% margin, are those that are in the higher-normal readings according to search I did search on it on a very informative medical site.

I posted about orthopnea with typical astha on two other sites and immediately had other asthma patients relating the fact that thier breathing becomes very uncomfortable lying flat on their backs. I'm convinced it is indeed a common problem in non-cardiac asthma patients.

Thank you!

[marieann288]

I think you had congestive heart failure you would know it and would be having big needles stuck into your lungs to have the fluids taken out. Don't worry about that.

It sounds like it is common from reading above and from my own personal experience. Lying on my back is difficult and uncomfortable. When I go to the dentist, or massage therapist or go to have a facial I am always more comfortable elevated, otherwise I start wheezing.

[LowMac]

I wanted to add that I got my chest exray back which showed normal size heart and no abnormal lung tissue or cardiopulmonary findings of any kind.

I also found lots of info on a test called the "BNP"  (B-type natriuretic peptide) and asked my doctor to order it for me. It is a very accurate marker for detecting heart enlargement, which is what Chronic Heart Failure actually is.

If your BNP level is at below 100 (<100), they can pretty much rule out heart failure because it is a hormone released due to stretching of the heart valves and does not go away unless the valves are brought back down to normal size via treatment.

While a reading of 100 or more would likely only indicate the very early onset of CHF, it still considered mild even if the level is "300". If it reaches "600" it is considered moderate and readings of "900" and above indicate severe CHF.

I was pleased to see my result was very low, at "4".

This, along with my normal chest exray gave me assurance that my asthma has no cardiac involvement. I do have acid reflux disease - many years and over time believe it contributed greatly to my adult onset asthma. I actually choked on stomach acid several times, months preceeding a worsening onset of my asthma.

"Orthopnea" (difficult breathing when lying flat on your back) is listed for GERD and some MD sources believe it may be that the lungs tighten with supine position in attempt to keep acid from entering them. It's a protection mechanism by the body.

I was very surprized to see that my posts had no replies on them after all these weeks. This is the first forum I've ever posted on, in which no one posted a reply. No big deal but did want to add the update and do appreciate the opportunity.

[LowMac]

I also posted a similar question at the about.com asthma forum last night and two fellow asthma patients relpied already, saying they experience the same problem of breathing difficulty when lying flat on their backs. Both said it happens to them immediately upon laying down even if they are not having an asthma flare but like me, they can sleep on their sides or stmach. Apparently this is common with asthma.

I also found medical sources saying orthopnea can occur in acid reflux sufferers of which I also have (GERD). Combine the two disorders and it probably aggravates the issue further.   ...Interesting!