Help for Diastolic Dysfunction?

[GW45]

Hello, I'm a 45 year old male, never smoked, in fairly good physical cond. 6 years ago I began experiencing shortness of breath, I went to my doctor and he put me in the hospital. I had 17 blood clots in my right lung, at least that many in my left. (The doctors checked my heart and said I had a big heart but nothing was wrong with it.)They put me on coumadin and sent me home. After about a week my shortness of breath began to worsen, to the point I couldn't get dressed without gasping for air. The doctor put me back in the hospital for a lung biopsy. He told me something got in my lungs and literally ate my lungs, I now have about 45% left. He prescribed a high dosage of prednisone 70mg daily for 2 weeks then slowly began tapering it down. After 4 days on prednisone I began to feel better, eventually I felt really good, but a couple of month's after I got off the prednisone my shortness of breath returned. So for the last 6 years I've been on 10-20 mg everyother day, this has worked so-so, but I have been able to work. Last year the company I work for switched insurance companies, I was forced to find new doctors, after a couple of visits and a new cat scan, the doctor told me my shortness of breath is being caused by Diastolic Dysfunction. What are the possible treatments available, what questions should I be discussing with my doctor. My shortness of breath appears to be worsening even with me on steroids. Any help would be greatly appreciated.  

[GW45]

Thank you for your time, I have a doctor's appt. in June, I'll keep you posted.

[kenkeith]

Water retention can be a side effect of prednisone.  If you have had a major increase in water retention this could cause your breathing symptoms.  

If your heart is causing SOB, an increase in fluids (side effect of med) increases the volume of blood and this stresses the heart and may reduce the cardiac output and less oxygenated blood output with each heartbeat can cause shortness of breath. Medication to reduce fluids (diuretic) would help.

Diastolic dysfunction is a condition that reduces the filling capacity as the left ventrical walls are less flexible and may have thickened.  As a result there is less blood in heart's chamber during the filling phase (diastolic) and during systole (pumping phase) there may or may not be any loss of pumping functionality.  With less blood pumped with each stroke, and with or without impaired pumping contractions the symptoms can be SOB.  Treatement would be to reduce the heart's afterload...diuretic, ACE inhibitor, a beta blocker.

[grendslori]

Hypertrophic Cardiomyopathy causes Diastolic Dysfunction so the first thing you want to ask your doctory is if this is the problem. I would think it is because you mentioned that your heart was enlarged. SOB is common with this disease as it progresses. You need to have Holter Studies done as well as an EP Study done to rule out problems with arrhythmias. This disease can cause a sudden death event (like the sport players on the field who die suddenly during the game) Calcium channel blockers are usually the choice treatment with transplant as an ending treatment.