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Doctors' Answers to "Frequently Asked Questions" - Dyspnea


These comments are made for the purpose of discussion and should NOT be used as recommendations for or against therapies or other treatments. An indi vidual patient is always advised to consult their own physician.

[posted 02/6/2000]
Question: I'm 34 and was diagnosed with SLE in 1994. Overall, my flares have been rather mild, experiencing low-grade fever, low platelets, pericarditis, skin rash, achiness and exhaustion. I have felt pretty well during the past two years except for heart palpitations that my doctor felt was nothing to worry about. About 1 month ago I visited my primary MD with complaints of shortness of breath and a tightness in my lungs. It felt as though my lungs weren't expanding enough. He said my lungs sounded like that of an asthmatic (very tight)and that I had bronchitis, but my lungs sounded good and there was no need for an xray. I was prescribed Prednisone for 5 days, antibiotics for 10. I am still suffering from shortness of breath and the episodes occur more frequently. I can hold my breath for only a few seconds. I do not have a fever, but sometimes experience a dry cough. I had an echocardiogram, which came out normal. Should I insist on an xray? Why is this getting worse?

Answer: Lupus can affect the lung in some patients. This needs to be checked with some fairly advanced pulmonary disease. You need a blood gas, a blood gas with exercise and pulmonary function tests with diffusing capacity. Ensure you get the diffusing capacity. Also, some patients with lupus will form clots. If quiesent, small clots would also do this. See a specialist, this needs attention.

[posted 10/9/1999]
Question: I recently underwent double angioplasty. I am taking 50 mg
toprol xl each morning. I enjoy playing tennis but find it
difficult,do to shortness of breath. As an experiment I
took an extra 50mg tablet immediately before playing and
seemedto have a dramatically good result. Does this make
sense?
and is it risky?

Answer: Sounds like you are still experiencing angina. This shortness of breath would be called an angina equivalent. Get a stress echo to ensure the angioplasty is till open! Many patients experiences shortness of breath with beta blockers, but if increasing the dosage helps, something is not right.

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