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Shortness of breath on exertion? Instead of ignoring - go get tested - Walla! health

2021-07-28T08:07:45.358Z


Suffering from shortness of breath on exertion? With the advent of treatments that can stop the progression of interstitial lung diseases, causing irreversible lung damage, the need for early diagnosis increases


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  • Routine in the shade of the corona

Shortness of breath on exertion?

Instead of ignoring, go get tested

With the advent of treatments that can stop the progression of interstitial lung diseases, which often cause irreversible damage to the lungs, and while the corona plague raises the incidence of pulmonary fibrosis, the need for early diagnosis and great attention to symptoms increases significantly

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  • Shortness of breath

Dr. Amir Bar-Shai, in collaboration with the Association for Patient Rights

Wednesday, July 28, 2021, 9 p.m.

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Interstitial lung diseases, or ILDs for short, are a group of diseases that are characterized by damage to the lung tissue and the connective tissues within the lung.

They impair lung function and transport oxygen from the lungs to the bloodstream, tissues and all organs of the body.

The damage is getting worse, the lungs often go through a process of scarring (fibrosis) and in some cases the disease progresses and becomes dangerous (PF-ILD).



The causes of lung tissue damage are very numerous, and can appear over a wide age range.

The causes may be known, such as autoimmune diseases, environmental exposure, occupational exposure, exposure to various drugs and so on, or the cause is unknown (idiopathic disease).

Compared to COPD and lung cancer, in the case of PF-ILD smoking is not a direct risk factor.

In some cases the disease is reversible, when there is only an inflammatory component, then appropriate treatment can lead to improvement in the condition, but in other cases scarring and irreversible damage occurs.

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Until 2014, there was no treatment that could, in a proven way, slow down the rate of deterioration of diseases in which there was scarring of the lungs.

In the same year, two drugs entered the treatment arsenal, acting by different mechanisms, to prevent scar formation, drugs called in medical parlance 'antifibrotic'.

At first, the drugs were shown to help with only one type of disease - IPF (idiopathic pulmonary fibrosis), and it was found that they slowed the rate of disease progression and later even reduced the mortality rate.

It is important to diagnose the disease while a woman puts a hand on her chest (Photo: ShutterStock)

In the last two years it has been shown that one of these drugs slows the rate of deterioration of the scar process and lung function in other non-IPF diseases, such as scleroderma with pulmonary involvement, and recently also in advanced pulmonary fibrosis for any reason.

The drug has been approved by the FDA to treat these diseases, and has now also entered the Israeli drug basket.

It is important to diagnose in time

But in order for the treatment to be effective and the irreversible damage to be prevented, it is important to diagnose the disease in time.

The problem is that PF-ILD has symptoms that can appear in a variety of other lung diseases, and even in various heart diseases, symptoms such as shortness of breath, cough, phlegm, shortness of breath on exertion and chronic fatigue.

And because the range of risk factors is wide, the diagnosis of the disease becomes more complex.



Sometimes a patient will come to the doctor for the first time to understand why after a few steps he feels he lacks breathing air.

It is important for the doctor to check the cause of shortness of breath, especially when it comes to a generally healthy person.

It is important to remember that sometimes the patient comes to the doctor and does not describe respiratory symptoms at all, but in more directed questions (such as "Do you manage to climb stairs easily", "Does he suffer from a prolonged cough" etc.) the symptoms will be mentioned.

In any case where there is a suspicion it is important to make the inquiry as soon as possible

In any case of complaints about these symptoms, it is important that doctors and medical staff as a whole know how to raise as specific and specific questions as possible, in an attempt to identify risk factors for interstitial disease and at the same time send for auxiliary tests that will lead to diagnosis.

Since these are not common diseases, no screening tests are performed for them, so in any case there is a suspicion it is important to carry out the investigation as soon as possible.

Diagnosis of pulmonary fibrosis includes a full lung function test, which examines lung volumes and the passage of oxygen and diffusion into the bloodstream, as well as an imaging test using high-resolution CT.

Uncommon disease.

Doctor looks at photo of lungs (Photo: ShutterStock)

Lung scarring can also be caused due to coronary heart disease.

Many recovering from corona disease suffer from respiratory symptoms for many months after the disease, and imaging tests show healthy scars, some of which are irreversible.

Because of this, any recovering from corona who continues to suffer from respiratory symptoms must consult a pulmonologist (pulmonologist) and perform appropriate tests to identify or rule out significant lung damage that requires attention and treatment.

Hence we expect that in the near future more and more patients with pulmonary fibrosis will be diagnosed worldwide.



Therefore, when a person suffers from shortness of breath, it is important that he does not try to "get used" to it and does not excuse it with poor physical fitness or any other reason.

Anyone who feels short of air during an effort is important to check.

True, this may be due to poor fitness, but it may be the first step in early diagnosis and life-saving treatment.



The author is Dr. Amir Bar-Shai, Director of the Department of Pulmonary Medicine, at Barzilai University Medical Center

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Source: walla

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