It’s a different path for each individual which is why pulmonary fibrosis is so difficult to diagnose. It takes two years on average for patients to receive their PF diagnosis.
Obtaining a Diagnosis
Patients with PF experience symptoms that are often subtle and similar to other lung disorders. To diagnose PF, a doctor will take a complete medical history and perform a thorough physical examination. During this examination, the doctor will listen to the patient’s chest to determine if their lungs are producing any abnormal sounds while breathing.
Types of pulmonary fibrosis
Once a doctor suspects pulmonary fibrosis, the next step is to try to diagnose the specific type of PF— there are more than 200 different kinds. Doctors typically start by asking questions, performing a careful physical examination, and ordering several blood tests.
Diagnostic Tests or Procedures
Helps the clinician view lung structures, look for scar tissue, and assess patterns of scarring.
Radiologic machines are used to take pictures of your lungs, such as x-ray or High-Resolution Computer Tomography (HRCT).
Pulmonary Function Test
Measures the degree of impairment in lung function using a device with a mouthpiece to measure a patient’s breathing capacity.
Exercise Test or Desaturation Study
Measures how well the lungs and heart respond to physical activity and evaluate oxygen levels with exertion by monitoring the patient while using a treadmill or stationary bicycle.
Six Minute Walk Test (SMWT)
Measures the distance a person can walk as well as lung function during the walk. During this test the patient walks on a flat surface as far as possible in six minutes.
A procedure in which a lung tissue sample is obtained through a bronchoscope or by means of a small surgical incision (VATS – video-assisted thoracic surgery) between the ribs (open-lung biopsy) for direct examination
Symptoms of Pulmonary Fibrosis
Symptoms usually have a gradual onset and may include:
Three Consequences of PF
Breathing is harder
Scar tissue and inflammation makes it harder to breathe. It takes a greater effort to inhale, causing a feeling of breathlessness, or shortness of breath, especially with exertion. The more scar tissue present in the lungs, the less air they can hold.
Blood lacks oxygen
Scar tissue inhibits the transfer of oxygen from the lung’s air sacs into the blood. For many people living with pulmonary fibrosis, oxygen levels are only slightly reduced while in a resting state, but drops significantly more with exertion. Doctors often prescribe supplemental oxygen. As pulmonary fibrosis progresses, oxygen may be needed 24/7 and the flow rate may need to increase.
“Crackles” in the lung
The doctor may indicate that “crackles” were heard in the lungs, similar to Velcro being pulled apart. This is very common, although not everyone has them. Crackles can be heard in many lung diseases including PF, pneumonia, or a buildup of fluid in the lungs from heart failure.
More on Diagnosis
ILD respirologists Dr. Amanda Grant-Orser and Dr. Kerri Johannson discuss how genetics can be an important tool for patients with ILD, shared the results of a recent national patient survey, and explained genetic testing in Canada.
In this webinar, Dr. Matthew Binnie discusses how to navigate a new pulmonary fibrosis diagnosis . Dr. Binnie is an Assistant Professor at the University of Toronto and Staff Physician at the Toronto Lung Transplant Program.
Learn how new Dual Energy X-ray technology can better detect, monitor progression, and speed up pulmonary fibrosis treatment.
Tune in as Dr. Lawrence Homik, a community-based respirologist helps patients and caregivers understand the basics of pulmonary fibrosis.
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