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I Am 49 Years / Male. Height 183 Cm /
Question: I am 49 years / male. Height 183 cm / Weight 103 kg / BP varies from 150 to 170 by 80 to 90.
I feel a bit breathless on exertion, for example when I rise up from sitting on the floor. I also suffer from sleep apnea (AHI 29.3 / ODI 24). My other symptoms: Frequent chest pains often at rest. Lightheadedness. Fatigue. Imbalance / unsteadiness.
Cardiac status: Angiogram in 2015 showed only minor blocks. CT angio in 2018 also showed minor blocks and superficial myocardial bridging of 6 CM in LAD. Stress test in 2015 was positive. Due to negative angiogram, cardiologist feels no cardiac cause of chest pain / related symptoms.
Echo done recently shows hyper contractile LV systolic function. Mild to moderate LV diastolic dysfunction and mild PAH (PASP=48mmHg). Earlier echo showed LV hypertrophy (maybe HCM) but current one shows IVS 11 & LVPW 10 (earlier they were both about 14.7)
Referred to pulmonologist. Did PFT. I have attached the result. Basically FVC 63%, FEV1 64%, FEV1/FVC 103%, FEF 25-75 61%
My questions:
1. Do I have lung disease? Is it restrictive or obstructive? Is it mild or moderate or severe?
2. Is the lung disease, if any, a consequence of sleep apnea? Will the lung disease be progressive?
3. Can my chest pains and other symptoms be related to the lungs issue?
4. Is the mild PAH cause for worry? Should it be investigated further?
5. Do I need to do any further tests for the lungs?
Thank you
I feel a bit breathless on exertion, for example when I rise up from sitting on the floor. I also suffer from sleep apnea (AHI 29.3 / ODI 24). My other symptoms: Frequent chest pains often at rest. Lightheadedness. Fatigue. Imbalance / unsteadiness.
Cardiac status: Angiogram in 2015 showed only minor blocks. CT angio in 2018 also showed minor blocks and superficial myocardial bridging of 6 CM in LAD. Stress test in 2015 was positive. Due to negative angiogram, cardiologist feels no cardiac cause of chest pain / related symptoms.
Echo done recently shows hyper contractile LV systolic function. Mild to moderate LV diastolic dysfunction and mild PAH (PASP=48mmHg). Earlier echo showed LV hypertrophy (maybe HCM) but current one shows IVS 11 & LVPW 10 (earlier they were both about 14.7)
Referred to pulmonologist. Did PFT. I have attached the result. Basically FVC 63%, FEV1 64%, FEV1/FVC 103%, FEF 25-75 61%
My questions:
1. Do I have lung disease? Is it restrictive or obstructive? Is it mild or moderate or severe?
2. Is the lung disease, if any, a consequence of sleep apnea? Will the lung disease be progressive?
3. Can my chest pains and other symptoms be related to the lungs issue?
4. Is the mild PAH cause for worry? Should it be investigated further?
5. Do I need to do any further tests for the lungs?
Thank you
I am 49 years / male. Height 183 cm / Weight 103 kg / BP varies from 150 to 170 by 80 to 90.
I feel a bit breathless on exertion, for example when I rise up from sitting on the floor. I also suffer from sleep apnea (AHI 29.3 / ODI 24). My other symptoms: Frequent chest pains often at rest. Lightheadedness. Fatigue. Imbalance / unsteadiness.
Cardiac status: Angiogram in 2015 showed only minor blocks. CT angio in 2018 also showed minor blocks and superficial myocardial bridging of 6 CM in LAD. Stress test in 2015 was positive. Due to negative angiogram, cardiologist feels no cardiac cause of chest pain / related symptoms.
Echo done recently shows hyper contractile LV systolic function. Mild to moderate LV diastolic dysfunction and mild PAH (PASP=48mmHg). Earlier echo showed LV hypertrophy (maybe HCM) but current one shows IVS 11 & LVPW 10 (earlier they were both about 14.7)
Referred to pulmonologist. Did PFT. I have attached the result. Basically FVC 63%, FEV1 64%, FEV1/FVC 103%, FEF 25-75 61%
My questions:
1. Do I have lung disease? Is it restrictive or obstructive? Is it mild or moderate or severe?
2. Is the lung disease, if any, a consequence of sleep apnea? Will the lung disease be progressive?
3. Can my chest pains and other symptoms be related to the lungs issue?
4. Is the mild PAH cause for worry? Should it be investigated further?
5. Do I need to do any further tests for the lungs?
Thank you
I feel a bit breathless on exertion, for example when I rise up from sitting on the floor. I also suffer from sleep apnea (AHI 29.3 / ODI 24). My other symptoms: Frequent chest pains often at rest. Lightheadedness. Fatigue. Imbalance / unsteadiness.
Cardiac status: Angiogram in 2015 showed only minor blocks. CT angio in 2018 also showed minor blocks and superficial myocardial bridging of 6 CM in LAD. Stress test in 2015 was positive. Due to negative angiogram, cardiologist feels no cardiac cause of chest pain / related symptoms.
Echo done recently shows hyper contractile LV systolic function. Mild to moderate LV diastolic dysfunction and mild PAH (PASP=48mmHg). Earlier echo showed LV hypertrophy (maybe HCM) but current one shows IVS 11 & LVPW 10 (earlier they were both about 14.7)
Referred to pulmonologist. Did PFT. I have attached the result. Basically FVC 63%, FEV1 64%, FEV1/FVC 103%, FEF 25-75 61%
My questions:
1. Do I have lung disease? Is it restrictive or obstructive? Is it mild or moderate or severe?
2. Is the lung disease, if any, a consequence of sleep apnea? Will the lung disease be progressive?
3. Can my chest pains and other symptoms be related to the lungs issue?
4. Is the mild PAH cause for worry? Should it be investigated further?
5. Do I need to do any further tests for the lungs?
Thank you
Brief Answer:
Yes, your sy are mostly due to sleep apnea.
Detailed Answer:
Thanks for your question on Ask a doctor forum.
I can understand your concern.
I have gone through the attachments.
Answer to your 1st question.
You have mixed pattern (obstructive and restrictive pattern). It is more likely to be moderate.
Answer to your 2nd question.
Yes, it is mostly due to sleep apnea
Answer to your 3rd question.
Yes, it is progressive.
Answer to your 4th question
Yes, your chest pain, breathlessness etc are due to lung condition.
Answer to your 5th question.
Yes, mild PAH is worrisome and in future it will worse.
Answer to your 6th quo.
No need for further investigation.
Hope I have solved your query. I will be happy to help you further. Wish you good health. Thanks
Yes, your sy are mostly due to sleep apnea.
Detailed Answer:
Thanks for your question on Ask a doctor forum.
I can understand your concern.
I have gone through the attachments.
Answer to your 1st question.
You have mixed pattern (obstructive and restrictive pattern). It is more likely to be moderate.
Answer to your 2nd question.
Yes, it is mostly due to sleep apnea
Answer to your 3rd question.
Yes, it is progressive.
Answer to your 4th question
Yes, your chest pain, breathlessness etc are due to lung condition.
Answer to your 5th question.
Yes, mild PAH is worrisome and in future it will worse.
Answer to your 6th quo.
No need for further investigation.
Hope I have solved your query. I will be happy to help you further. Wish you good health. Thanks
Above answer was peer-reviewed by :
Dr. Prasad
Brief Answer:
Yes, your sy are mostly due to sleep apnea.
Detailed Answer:
Thanks for your question on Ask a doctor forum.
I can understand your concern.
I have gone through the attachments.
Answer to your 1st question.
You have mixed pattern (obstructive and restrictive pattern). It is more likely to be moderate.
Answer to your 2nd question.
Yes, it is mostly due to sleep apnea
Answer to your 3rd question.
Yes, it is progressive.
Answer to your 4th question
Yes, your chest pain, breathlessness etc are due to lung condition.
Answer to your 5th question.
Yes, mild PAH is worrisome and in future it will worse.
Answer to your 6th quo.
No need for further investigation.
Hope I have solved your query. I will be happy to help you further. Wish you good health. Thanks
Yes, your sy are mostly due to sleep apnea.
Detailed Answer:
Thanks for your question on Ask a doctor forum.
I can understand your concern.
I have gone through the attachments.
Answer to your 1st question.
You have mixed pattern (obstructive and restrictive pattern). It is more likely to be moderate.
Answer to your 2nd question.
Yes, it is mostly due to sleep apnea
Answer to your 3rd question.
Yes, it is progressive.
Answer to your 4th question
Yes, your chest pain, breathlessness etc are due to lung condition.
Answer to your 5th question.
Yes, mild PAH is worrisome and in future it will worse.
Answer to your 6th quo.
No need for further investigation.
Hope I have solved your query. I will be happy to help you further. Wish you good health. Thanks
Above answer was peer-reviewed by :
Dr. Prasad
Thank you for the prompt response. I have a few more queries, please.
1. Since the lungs issue is related to sleep apnea; if I am able to treat the sleep apnea by using CPAP (currently not using) will the lungs issue get resolved? Could there be another independent cause of lung restriction like fibrosis, etc.?
2. What treatment (medicine) do you recommend for the lung issue and also for the PAH? Will any or both these issues reduce life span? What is the prognosis? Is it a serous issue?
3. Echo shows two measurements (IVS and LVPW) reduced since last time from about 14.7 to about 11 mm. Is this possible? What is hypercontractile LVS function?
4. Can the myocardial bridging also cause chest pains and lightheadness?
Thank you.
1. Since the lungs issue is related to sleep apnea; if I am able to treat the sleep apnea by using CPAP (currently not using) will the lungs issue get resolved? Could there be another independent cause of lung restriction like fibrosis, etc.?
2. What treatment (medicine) do you recommend for the lung issue and also for the PAH? Will any or both these issues reduce life span? What is the prognosis? Is it a serous issue?
3. Echo shows two measurements (IVS and LVPW) reduced since last time from about 14.7 to about 11 mm. Is this possible? What is hypercontractile LVS function?
4. Can the myocardial bridging also cause chest pains and lightheadness?
Thank you.
Thank you for the prompt response. I have a few more queries, please.
1. Since the lungs issue is related to sleep apnea; if I am able to treat the sleep apnea by using CPAP (currently not using) will the lungs issue get resolved? Could there be another independent cause of lung restriction like fibrosis, etc.?
2. What treatment (medicine) do you recommend for the lung issue and also for the PAH? Will any or both these issues reduce life span? What is the prognosis? Is it a serous issue?
3. Echo shows two measurements (IVS and LVPW) reduced since last time from about 14.7 to about 11 mm. Is this possible? What is hypercontractile LVS function?
4. Can the myocardial bridging also cause chest pains and lightheadness?
Thank you.
1. Since the lungs issue is related to sleep apnea; if I am able to treat the sleep apnea by using CPAP (currently not using) will the lungs issue get resolved? Could there be another independent cause of lung restriction like fibrosis, etc.?
2. What treatment (medicine) do you recommend for the lung issue and also for the PAH? Will any or both these issues reduce life span? What is the prognosis? Is it a serous issue?
3. Echo shows two measurements (IVS and LVPW) reduced since last time from about 14.7 to about 11 mm. Is this possible? What is hypercontractile LVS function?
4. Can the myocardial bridging also cause chest pains and lightheadness?
Thank you.
Brief Answer:
Treatment of Sleep apnea is must in your case.
Detailed Answer:
Thanks for your follow up question on Ask a doctor forum.
Sorry for late reply as I was busy.
Answer to your 1st question.
For independent cause, you need to get done CT thorax.
If CT thorax is normal then your PFT abnormality is due to Sleep apnea only.
So if CT is normal and you treat sleep apnea optimally, there is high chance of reversal of PFT abnormality.
Answer to your 2nd question.
Both these, PFT abnormality and PAH definitely reduce life span. Moreover, they will worsen gradually if you don't treat sleep apnea now.
At present, no seperate treatment needed for them, just start sleep apnea treatment.
Answer to your 3rd question.
Yes, it is possible.
And hypercontractile LVS function means your heart is under pressure.
Answer to your 4th question.
No, they can not cause chest pain.
I will be happy to help you further. Wish you good health. Again sorry for the late reply. Thanks.
Treatment of Sleep apnea is must in your case.
Detailed Answer:
Thanks for your follow up question on Ask a doctor forum.
Sorry for late reply as I was busy.
Answer to your 1st question.
For independent cause, you need to get done CT thorax.
If CT thorax is normal then your PFT abnormality is due to Sleep apnea only.
So if CT is normal and you treat sleep apnea optimally, there is high chance of reversal of PFT abnormality.
Answer to your 2nd question.
Both these, PFT abnormality and PAH definitely reduce life span. Moreover, they will worsen gradually if you don't treat sleep apnea now.
At present, no seperate treatment needed for them, just start sleep apnea treatment.
Answer to your 3rd question.
Yes, it is possible.
And hypercontractile LVS function means your heart is under pressure.
Answer to your 4th question.
No, they can not cause chest pain.
I will be happy to help you further. Wish you good health. Again sorry for the late reply. Thanks.
Above answer was peer-reviewed by :
Dr. Nagamani Ng
Brief Answer:
Treatment of Sleep apnea is must in your case.
Detailed Answer:
Thanks for your follow up question on Ask a doctor forum.
Sorry for late reply as I was busy.
Answer to your 1st question.
For independent cause, you need to get done CT thorax.
If CT thorax is normal then your PFT abnormality is due to Sleep apnea only.
So if CT is normal and you treat sleep apnea optimally, there is high chance of reversal of PFT abnormality.
Answer to your 2nd question.
Both these, PFT abnormality and PAH definitely reduce life span. Moreover, they will worsen gradually if you don't treat sleep apnea now.
At present, no seperate treatment needed for them, just start sleep apnea treatment.
Answer to your 3rd question.
Yes, it is possible.
And hypercontractile LVS function means your heart is under pressure.
Answer to your 4th question.
No, they can not cause chest pain.
I will be happy to help you further. Wish you good health. Again sorry for the late reply. Thanks.
Treatment of Sleep apnea is must in your case.
Detailed Answer:
Thanks for your follow up question on Ask a doctor forum.
Sorry for late reply as I was busy.
Answer to your 1st question.
For independent cause, you need to get done CT thorax.
If CT thorax is normal then your PFT abnormality is due to Sleep apnea only.
So if CT is normal and you treat sleep apnea optimally, there is high chance of reversal of PFT abnormality.
Answer to your 2nd question.
Both these, PFT abnormality and PAH definitely reduce life span. Moreover, they will worsen gradually if you don't treat sleep apnea now.
At present, no seperate treatment needed for them, just start sleep apnea treatment.
Answer to your 3rd question.
Yes, it is possible.
And hypercontractile LVS function means your heart is under pressure.
Answer to your 4th question.
No, they can not cause chest pain.
I will be happy to help you further. Wish you good health. Again sorry for the late reply. Thanks.
Above answer was peer-reviewed by :
Dr. Nagamani Ng
Thank you, Doctor, for your clear and concise reply.
1. This is just for my knowledge. How does this PFT show 'mixed pattern'? I understand that a low FVC means my lungs are not able to completely get filled with air during inhalation. Which number in the test also shows 'obstruction'?
2. One more symptom: There is some light swelling in my ankles mostly in the evenings. It is usually not there when I wake up in the morning.
Thank you.
1. This is just for my knowledge. How does this PFT show 'mixed pattern'? I understand that a low FVC means my lungs are not able to completely get filled with air during inhalation. Which number in the test also shows 'obstruction'?
2. One more symptom: There is some light swelling in my ankles mostly in the evenings. It is usually not there when I wake up in the morning.
Thank you.
Thank you, Doctor, for your clear and concise reply.
1. This is just for my knowledge. How does this PFT show 'mixed pattern'? I understand that a low FVC means my lungs are not able to completely get filled with air during inhalation. Which number in the test also shows 'obstruction'?
2. One more symptom: There is some light swelling in my ankles mostly in the evenings. It is usually not there when I wake up in the morning.
Thank you.
1. This is just for my knowledge. How does this PFT show 'mixed pattern'? I understand that a low FVC means my lungs are not able to completely get filled with air during inhalation. Which number in the test also shows 'obstruction'?
2. One more symptom: There is some light swelling in my ankles mostly in the evenings. It is usually not there when I wake up in the morning.
Thank you.
Brief Answer:
Low FEV1 is suggestive of obstructive pattern.
Detailed Answer:
Thanks for your follow up question on Ask a doctor forum.
I can understand your concern.
Obstructive pattern is due to low FEV1.
You have both, low FEV1 and FVC, so mixed pattern is there.
Leg swelling in evening can be due to variety of diseases.
So please let me know
1. Have you ever undergone any blood reports like liver function test, kidney function test?.
2. Do you drink alcohol?
Please reply me answers of above asked questions, so that I can guide you better. I will be happy to help you further. Wish you good health. Thanks.
Low FEV1 is suggestive of obstructive pattern.
Detailed Answer:
Thanks for your follow up question on Ask a doctor forum.
I can understand your concern.
Obstructive pattern is due to low FEV1.
You have both, low FEV1 and FVC, so mixed pattern is there.
Leg swelling in evening can be due to variety of diseases.
So please let me know
1. Have you ever undergone any blood reports like liver function test, kidney function test?.
2. Do you drink alcohol?
Please reply me answers of above asked questions, so that I can guide you better. I will be happy to help you further. Wish you good health. Thanks.
Above answer was peer-reviewed by :
Dr. Vaishalee Punj
Brief Answer:
Low FEV1 is suggestive of obstructive pattern.
Detailed Answer:
Thanks for your follow up question on Ask a doctor forum.
I can understand your concern.
Obstructive pattern is due to low FEV1.
You have both, low FEV1 and FVC, so mixed pattern is there.
Leg swelling in evening can be due to variety of diseases.
So please let me know
1. Have you ever undergone any blood reports like liver function test, kidney function test?.
2. Do you drink alcohol?
Please reply me answers of above asked questions, so that I can guide you better. I will be happy to help you further. Wish you good health. Thanks.
Low FEV1 is suggestive of obstructive pattern.
Detailed Answer:
Thanks for your follow up question on Ask a doctor forum.
I can understand your concern.
Obstructive pattern is due to low FEV1.
You have both, low FEV1 and FVC, so mixed pattern is there.
Leg swelling in evening can be due to variety of diseases.
So please let me know
1. Have you ever undergone any blood reports like liver function test, kidney function test?.
2. Do you drink alcohol?
Please reply me answers of above asked questions, so that I can guide you better. I will be happy to help you further. Wish you good health. Thanks.
Above answer was peer-reviewed by :
Dr. Vaishalee Punj
Thank you, Doctor, for the reply.
I had tested for creatinine and it was in the normal range a few months back. Liver function tests - not done recently i.e. not within last year or so.
Also, I don't drink alcohol. I don't smoke.
Thank you.
I had tested for creatinine and it was in the normal range a few months back. Liver function tests - not done recently i.e. not within last year or so.
Also, I don't drink alcohol. I don't smoke.
Thank you.
Thank you, Doctor, for the reply.
I had tested for creatinine and it was in the normal range a few months back. Liver function tests - not done recently i.e. not within last year or so.
Also, I don't drink alcohol. I don't smoke.
Thank you.
I had tested for creatinine and it was in the normal range a few months back. Liver function tests - not done recently i.e. not within last year or so.
Also, I don't drink alcohol. I don't smoke.
Thank you.
Brief Answer:
Get done serum protein and thyroid function test.
Detailed Answer:
Thanks for your follow up question on Ask a doctor forum.
I can understand your concern.
In my opinion, you should get done thyroid function test and serum protein levels because hypothyroidism and low protein can also cause similar edema feet.
I will be happy to help you further. Wish you good health. Thanks.
Get done serum protein and thyroid function test.
Detailed Answer:
Thanks for your follow up question on Ask a doctor forum.
I can understand your concern.
In my opinion, you should get done thyroid function test and serum protein levels because hypothyroidism and low protein can also cause similar edema feet.
I will be happy to help you further. Wish you good health. Thanks.
Above answer was peer-reviewed by :
Dr. Yogesh D
Brief Answer:
Get done serum protein and thyroid function test.
Detailed Answer:
Thanks for your follow up question on Ask a doctor forum.
I can understand your concern.
In my opinion, you should get done thyroid function test and serum protein levels because hypothyroidism and low protein can also cause similar edema feet.
I will be happy to help you further. Wish you good health. Thanks.
Get done serum protein and thyroid function test.
Detailed Answer:
Thanks for your follow up question on Ask a doctor forum.
I can understand your concern.
In my opinion, you should get done thyroid function test and serum protein levels because hypothyroidism and low protein can also cause similar edema feet.
I will be happy to help you further. Wish you good health. Thanks.
Above answer was peer-reviewed by :
Dr. Yogesh D
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