The rapid decline in your husband’s health is puzzling and very worrisome, especially the rapid worsening of symptoms, suggestive of an acute progressive disorder of the heart or lungs; the severity of his symptoms is of great concern. I phrase the situation this way to convey a sense of urgency in establishing a diagnosis and initiating therapy, without delay. The test result information you provide, if valid, effectively rules out the common causes of such acute symptoms, such as classical pulmonary embolic disease and coronary artery disease with acute heart failure and raises the possibility of uncommon disorders.
One caveat is that in a circumstance such as this, tests that may ultimately provide a diagnosis (for example, heart catheterization, CT scanning of the lungs, echocardiograms) may be normal or marginally abnormal at the outset. In this category I would place conditions such as pulmonary hypertension (of whatever cause) interstitial lung disease (including acute bronchiolitis), inflammatory pulmonary vascular disease, cardiomyopathy, and constrictive pericarditis, The “right heart thickening” you mention could be an important early sign of pulmonary hypertension, not grossly elevated on the initial testing but rapidly progressive.
One specific form of pulmonary arterial hypertension (PAH) is pulmonary veno-occlusive disease (PVOD), characterized by widely disseminated clot formation in the pulmonary veins. With this relatively rare condition, narrowing or obliteration of the pulmonary arteries is found in approximately half the cases of PVOD.
It is clear that his doctors have been diligent in seeking to establish a diagnosis. They ave ordered all the conventionally appropriate tests. What is also clear to me is that your husband’s condition is rapidly progressive and there is an urgent need for diagnosis and treatment. There is no time for further speculation. I suggest that you and other members of your family meet with his physicians and request immediate consultation with the nearest University Hospital specialists in unusual cardiac diseases, pulmonary hypertension and interstitial lung disease. Do not delay. Feel free to share this message with his physicians.
Good luck
Thank you for your response. My husband has been referred to the Mayo Clinic. He is currently undergoing several tests. The possibilities you mentioned are being considered. I feel very confident the medical team at the Mayo Clinic will provide a diagnosis and treatment.
Again, thank you for taking the time to answer my post.