Breathing problems

[MaryWR]

I have had PMR since December. I also have a history of slight pulmonary hypertension. Over time my pulmonary arterial pressure returned to normal and pre PMR it was only slightly raised. I am now on 12.5mg prednisolone and high blood pressure medication.

Over the last 4-6 weeks I have noticed that my breathing has deteriorated a little and I am getting some crackly noises in my chest. Does anyone else experience this as a symptom of PMR? I have read that vasculitis can affect the blood vessels of the heart and lungs and wonder if this happens often.

Clearly I am a little worried about this and I am seeing my GP next week but I wanted some informed opinion before I go.

This is a wonderful forum and thanks to everyone for the invaluable support.

[Runrig01]

The crackling noises you describe is not a symptom of PMR. The Vasculitis related to PMR is GCA and in a number of patients can affect the Aorta and its branches, but does not affect the lung. It sounds like your breathing problem is a separate issue from your PMR. It would be worth getting checked out with you GP, it may be related to your pulmonary hypertension. Also Prednisolone can cause shortness of breath as one of its side effects. Hope it settles soon, Runrig x

[PMRpro Ambassador]

I haven't much to add to runrig's post - except that there is some evidence that there is a whole spectrum of PMR/GCA as well as other forms of vasculitis and it is perfectly possible that you have some vasculitis which is affecting the pulmonary vessels. One form of vasculitis that affects the lungs may present in the early stages as pulmonary hypertension. This particular vasculitis is normally seen in younger patients but can also occur in people in their 50s according to the literature.

If it were me, I would ask my GP to refer me to a respiratory specialist at the very least, possibly to a vasculitis specialist (but they are less common than chest physicians!).

[jinasc]

I would ask my GP for a referral for a scan (echo cardiograph) on the Aorta and Pulmonary Artery. Ths is recommended in the BSR Guidelines on the Treatment and Diagnosis of GCA after two years in. I know you have said you have PMR and not GCA but as they are all part of the same family it would be helpful to you to have this test.

Extract from BSR Guidelines.

IMAGING.

PATIENTS SHOULD HAVE CHEST RADIOGRAPHS EVERY TWO YEARS TO MONITOR AORTIC ANEURYSM.

IN SUSPECTED LARGE-VESSEL GCA, THIS MAY NEED SUPPLEMENTATION WITH ECHOCARDIGRAPHY, PTE, MRI/CT AS APPROPRIATE.