Does my chest CT show the cause of breathlessness, fatigue, and chest pain?

Question

Hi doctor,

I am a 50-year-old male, six feet tall, weighs about 220.46 lb. I feel breathlessness on exertion (even during simple walking, bending, etc.) and fatigued. I also face night-time breathing issues (OSA). I am not able to use CPAP (continuous positive airway pressure). I also suffer from frequent chest pains. Recently I was hospitalized with chest pain (with elevated Troponin). Before admission, I was required to have a screening CT chest to rule out COVID-19. The computed tomography (CT was normal for COVID-19 but had a couple of other findings that concern me. I also had a pulmonary function test (PFT) last year, which shows moderate issues. I attached both these reports. Please study them and let me know what the problems are. Are they serious? Do I need to do any further tests or treatment for these? Also, my cardiologist found only smaller blocks in my angio (along with a myocardial bridge), and he feels those should not be the cause of my breathlessness and chest pain. Can these lung issues be the cause of chest pain or breathlessness? Thank you.

Answer 1

Hi,

Welcome to icliniq.com. Thanks for the query. I can understand your concern. According to your statement, you have been suffering from breathlessness on exertion, fatigue, chest pain. Your HRCT (high-resolution computed tomography) of the chest (attachment removed to protect patient identity) has revealed that subpleural atelectatic changes in both lungs. And your PFT (pulmonary function test) has shown FEV1 (forced expiratory volume), FVC (forced vital capacity) decreased, and increased FEV1 or FVC ratio. According to your pulmonary function test, you may suffer from mixed lung disease and has characteristics of both obstructive and restrictive lung disease that mostly occur in COPD (chronic obstructive pulmonary disease), congestive heart failure, etc. Atelectatic changes in both lungs, according to high resolution computed tomography (HRCT) of the chest, also suggest those. In both COPD and congestive heart failure cases, such types of clinical features may be found from which you have been suffering now. In case of any other query, ask me.

Answer 2

Hi,

Welcome back to icliniq.com. Thanks for joining us again. Atelectasis is a condition in which the airways and air sacs in the lung or part of the lung collapse. Subpleural atelectasis, involving less than one bronchopulmonary segment, is the mildest form of lung atelectasis. Treatment of atelectasis depends on the cause. Mild atelectasis may go away without treatment. In some cases, surgical intervention may be needed. You can undergo some investigations like ECG (electrocardiography), echocardiogram (ECHO), reversibility test, magnetic resonance imaging (MRI) of the chest, CXR (chest radiograph), etc. to determine the underlying causes of your present sufferings then treat them accordingly. For chronic obstructive pulmonary disease (COPD), bronchodilators like Salbutamol, Cetirizine, Montelukast, Steroids, bronchodilator inhaler, a steroid inhaler, etc. be used. For CCF (Congestive cardiac failure), cardiac medications, diuretics like Furosemide, lipid-lowering agents, etc., can be used. Both COPD and congestive heart failure are serious diseases, and they can cause in the long run. In case of any other query, ask me.