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Need some Help here

Been short of breath as if im not getting enough oxygen from the air i breath and is worse when i am trying to sleep and run out of breath when i speak. Went  to Veterans Medical center had Stress Test Nuclear Myocardial Perfusion Scan and a Pulmonary Function Test and Here are the findings.
Stress: There is a small anterior wall perfusion defect which appears fixed. There is no evidence of reversibility.
In addition there is a small mild inferior wall perfusion defect mid to basal, also noted on resting images, mostly fixed. There may be a touch reversibility in the mid inferior to basal region, but this is not considered a definite
finding for ischemia. Bull's-eye quantitative polar map analysis does not detect any reversibility. EF/ Wall motion: There is normal left ventricular wall motion, ejection fraction is 65%. Normal EF is greater than 45%.
Pulmonary: 1. Pre-bronchodilator spirometry: Normal ratio. Normal FEV1, 84%. Normal FVC, 83%. Reduced mid-expiratory flows. Also there is flattening of the inspiratory limb of the flow volume loop. 2. Post-bronchodilator spirometry: Significant bronchodilator response. FEV1 96%. FVC 93%. #. Lung Volumes: No restrictive defect. There is evidence of air trapping.
4. Diffusion capacity: Normal.
So after testing nurse calls me and says you have COPD and i make appointment with Pulmonary Dr i goe to the appointment and he says my numbers are normal that i dont have COPD and makes me an appointment with the Cardio in which i am waiting for the appointment next month and i am having a very hard time breathing so much i almost went to the hospital last night.

Sound like Heart or Lungs?
Help Please.
2 Responses
20748650 tn?1521032211
Bit of both.. Mild copd, you probably just have some sort of trigger thats making these episodes worse.

Mild coronary artery disease as well.. Of particular interest in your case is the inferior posterior images. Fixed perfusion defect with no reversibility means just that.. Can't fix it.

Mechanically it looks as though the heart is doing ok based on the report.. Would have to see images to get a better idea.. However it deffinately looks like lungs would be more at fault.. Unless theres an underlying rhythm (electrical) issue that hasnt been discovered yet

With copd as a complicating factor they may wanna do cath or ct angio to take a closer look at the right side... This strategy would certainly be aggressive but given the risk for increased pulmonary pressures/disease progression it might pay to lay eyes on it.
4 Comments
I was talking to a nurse recently describing fluttering of my heart sometimes it will hurt for a second or two then stops, she says probably have A-Fib. What i dont understand is why the Pulmonary Dr. at the VA said to me he dont think i have COPD and made an appointment for a heart Dr. but that appointment is not until Dec 18. Im confused because the test say i do from what i read and i know nothing medically.  
I am her son  she needs  the   right  for all the pan for the hart
so I want do  want she Deserves her  name  Cheryl

Thats because nothing from those tests is significant.. Some disease present, but only mildly so.

Hence the lack of concern from the pulmonologist. Depending on your age, the doctors arent going to,be eexpecting a 'perfect' result.

Further none of your findings correlate with the kind of severe symotoms youre describing.

I think looking at the concerns you have about fluttering sensations may answer more questions. A holter monitor may be more beneficial.

If no electrical issues are found, id personally want to look at echocardiograms, maybe a stress echo.. If they havent done any recently. Maybe... Maybe a cath. Still nothing? Then its time to start looking at lungs again, like perhaps some sort of environmental trigger.
Thanks for your imput
20796928 tn?1510235350
I am her son  she needs  the   right  for all the pan for the hart
so I want do  want she Deserves
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