Dr. Kaushal Bhavsar
Pulmonology (Asthma Doctors)
The following is an actual conversation between an iCliniq user and a doctor that has been reviewed and published as a Premium Q&A.
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Patient's Query
Hello doctor,
I have recently visited a cardiologist for shortness of breath, but after doing all cardiac tests, the doctor said I do not have any heart problems. I have done the pulmonary function test (PFT) test, and I will attach the report. The test states mild diffusing capacity of lungs for carbon monoxide (DLCO) reduction and the possible cause is a pulmonary disease or something related to fibrosis or a lung clot. I have to undergo a computed tomography (CT) scan, but my appointment is scheduled the next month. Is DLCO reduction a serious issue, and should I go to emergency room (ER) and get a CT scan done right away? I do not know how my lungs got damaged. I never smoked and did not have any exposure to any gases or chemicals, or dust. The problem started four years ago. What does my carbon monoxide transfer coefficient (KCO) value suggest? If there is a clot, what should I do?
Hello,
Welcome to icliniq.com. I can understand your concern. I have gone through the reports you have attached (attachments removed to protect the patient's identity). Carbon monoxide transfer coefficient (KCO) is the carbon monoxide transfer coefficient. You should get a CT (computed tomography) pulmonary angiography done to rule out pulmonary embolism. May I know your oxygen saturation at rest and on exertion?
Patient's Query
Thank you doctor for the reply,
My oxygen saturation at rest is 98 % at room temperature. I am unsure after walking, but I had a stress test. My oxygen saturation was normal, but I do not remember the exact number. Should I visit the emergency room (ER) and get a computed tomography (CT) scan done, or can I wait for a month or two as my appointment is scheduled for the next month? Does my carbon monoxide transfer coefficient (KCO) number look normal? Do I need to take blood thinners regularly if there is a clot?
Hello,
Welcome back to icliniq.com. I can understand your concern. Is it possible for you to get a D-dimer test done? D-dimer is the screening testing for pulmonary embolism. Suppose it is negative; no need for CT (computed tomography) pulmonary angiography. If it is positive or high, then CT pulmonary angiography is needed.
Patient's Query
Thank you doctor for the reply,
I can undergo the D-dimer test. I can climb stairs and run as I do not have chest pain at that time. I run and jog for almost two kilometers at least two to three days a week. Sometimes at rest, I have shortness of breath or a few episodes at night. I recovered from COVID-19 five months ago. I have had this issue for the past four years. Do I need to go to the emergency room (ER) immediately so they can do all the necessary tests there? If it is (PE) pulmonary embolism , then is that completely curable? What causes this, and do I need blood thinners lifelong?
Hello,
Welcome back to icloiniq.com. I can understand your concern. I do not think it is pulmonary embolism, but you have low DLCO (diffusing capacity for carbon monoxide), so I suspect it. Otherwise, you do not have any clinical suspicion of PE (pulmonary embolism). Another possibility is stress and anxiety. Do you have any stress in your life? Sporadic breathing difficulty is common with stress and anxiety.
Patient's Query
Thank you doctor for the reply,
So what are other reasons for low diffusing capacity for carbon monoxide (DLCO)? Do you think it is something related to lung fibrosis or pulmonary hypertension? I have fear or anxiety about having health issues. So I checked my heart rate as online research tells many things, so I started ruling out the cases. What are the other causes of pulmonary embolism (PE)? I do not smoke or do not have contact with other chemicals. What can be the reason for early Interstitial lung disease or tissue scarring? Thank you.
Hello,
Welcome back to icliniq.com. I can understand your concern. No, I do not think you have lung fibrosis. The first symptom of lung fibrosis will be a dry and irritable cough. At your age of 32 years, pulmonary fibrosis is extremely rare unless and until you have a strong family history of pulmonary fibrosis. Some of the other causes for low DLCO (diffusing capacity for carbon monoxide) in your case might be technique-related issues. Do you have pulmonary hypertension?
Patient's Query
Thank you doctor for the reply,
I do not have pulmonary hypertension. What is the cause of pulmonary embolism (PE)? Overall I am healthy but do not know why I wake up at night. Why do I feel pain in the chest, under the ribs, or below the breast bone? Are my carbon monoxide transfer coefficient (KCO) values normal in the report as I am trying to understand and figure out the cause for low diffusing capacity of lungs for carbon monoxide (DLCO)? Online search also pointed towards the same thing, so I am worried about my DLCO level. Do you think it has mildly reduced? What actions do I need to take at this point?
Hello,
Welcome back to icliniq.com I can understand your concern. I still feel your symptoms are due to stress and anxiety. You do not have lung disease. I suggest you get a D-dimer test done. Suppose D-dimer is normal, then there is no need to worry about pulmonary embolism. If D-dimer is high, then CT (computed tomography) pulmonary angiography is necessary. Another less likely possibility for your symptoms is connective tissue disease (CTD). Have you heard about it?
Patient's Query
Thank you doctor for the reply,
What is connective tissue disease (CTD)? Lastly, It will take some time for me to get the computed tomography (CT) scan done; the current wait time is three months. Do I have shortness of breath due to stress and anxiety? How could I be fine if it is pulmonary embolism (PE) or any other pulmonary disease with no chest pain? The only worry I have right now is that I have to wait too long if it's PE. I should visit the emergency room (ER).
Hello,
Welcome back to icliniq.com. I suggest you get the D-dimer test done. The report will come on the same day. If it is elevated, pulmonary embolism can be suspected. I suggest you get a CT (computed tomography) coronary angiography done. Suppose D-dimer is normal; no need for CT pulmonary angiography. Once you see the normal CT pulmonary angiography report, your mind will be calm. CTD (connective tissue disease) is a multisystem disease that causes vague symptoms.
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Pulmonology (Asthma Doctors)
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