the Links Between Emphysema, Lung Nodules, and Blood Pressure Spikes

Q: the Links Between Emphysema, Lung Nodules, and Blood Pressure Spikes

Hello： Allow me to answer your questions in a simple bullet-point format.<br>1. <br>Is moderate significantly more severe than mild? (I do not smoke, but I have used strong chemical solvents to clean stubborn adhesives.) <br> Answer： From an imaging perspective, moderate is ind

Is there a connection between emphysema, pulmonary nodules, latent tuberculosis, and waking up at night with high blood pressure?

Hello Dr.
Chen, I just had a CT scan, and the result shows Moderate Bilateral Centrilobular Emphysema (I am currently abroad).
I would like to ask you a few questions:
1.
Is Moderate significantly more severe than mild? (I do not smoke, but I have previously used strong chemical solvents to clean stubborn adhesives.)
2.
I have latent tuberculosis; is it related to emphysema? Can both conditions occur simultaneously?
3.
Four years ago, my CT scan showed hundreds of nodules in my lungs; will this make my emphysema worse?
4.
Recently, I have been waking up in the middle of the night with difficulty breathing, feeling very uncomfortable, and experiencing whole-body tremors.
My blood pressure readings are consistently above 150/90, whereas I usually have low blood pressure (100/50).

I apologize for asking so many questions, and I appreciate you providing this platform for patients to inquire.
Thank you very much! Sincerely, Wu Xuan.

Wu Xuan, 60~69 year old female. Ask Date: 2018/04/10

Dr. Chen Junwei reply Pulmonology

Hello: Allow me to answer your questions in a simple bullet-point format.
1.
Is moderate significantly more severe than mild? (I do not smoke, but I have used strong chemical solvents to clean stubborn adhesives.)
Answer: From an imaging perspective, moderate is indeed more severe than mild.
However, the impact on respiratory function requires a detailed pulmonary function test.
I recommend that you arrange for further examination to clarify your current lung function status.
Centriacinar emphysema is mostly associated with smoking, but secondhand smoke or environmental pollution can also contribute.
2.
I have latent tuberculosis; is it related to emphysema? Can the two conditions occur simultaneously?
Answer: There is no direct correlation, and they do not occur simultaneously (unless there is long-term use of corticosteroids).
3.
Four years ago, a CT scan showed that I had hundreds of nodules in my lungs.
Will this worsen my emphysema?
Answer: I cannot comment further without seeing the imaging, but the nodules are likely related to occupational or environmental exposure.
They may contribute to worsening lung function alongside emphysema, but further testing is necessary to determine residual lung function status.
4.
Recently, I wake up at night feeling breathless, very uncomfortable, and trembling, with blood pressure readings consistently above 150/90.
However, I usually have low blood pressure (100/50).
Answer: The elevated blood pressure is likely related to your discomfort.
I recommend resting and measuring it again later.
The nighttime breathlessness may be related to emphysema, so I suggest consulting a pulmonologist for examination and treatment.

Reply Date: 2018/04/10

More Info

Hello, Wu Xuan,
Thank you for your questions regarding your recent CT findings and your health concerns. Let's address each of your questions in detail.

1. Severity of Moderate Emphysema: Yes, "moderate" emphysema is indeed a step up from "mild" emphysema. Emphysema is a progressive lung disease that involves damage to the alveoli (air sacs) in the lungs, leading to breathing difficulties. The classification of emphysema severity typically ranges from mild to moderate to severe, based on the extent of lung damage and the degree of airflow limitation. While you mentioned that you do not smoke, exposure to strong chemical solvents can also contribute to lung damage, similar to the effects of smoking.

2. Latent Tuberculosis and Emphysema: Latent tuberculosis (TB) is a condition where the TB bacteria are present in the body but are inactive and not causing symptoms. While latent TB itself does not directly cause emphysema, both conditions can coexist, especially in individuals with compromised lung function. If TB becomes active, it can lead to lung damage and exacerbate existing conditions like emphysema. It’s essential to monitor your lung health closely, especially if you have a history of TB.

3. Lung Nodules and Emphysema: The presence of lung nodules can complicate the clinical picture. While having multiple nodules does not necessarily worsen emphysema, it can indicate other underlying issues that may affect lung function. The nodules could be benign or malignant, and their nature should be evaluated by your healthcare provider. Regular follow-up imaging and possibly a biopsy may be necessary to determine the cause of the nodules and their impact on your overall lung health.

4. Breathing Difficulties and Blood Pressure Spikes: The symptoms you describe—waking up at night with difficulty breathing and experiencing shaking—are concerning. The spike in blood pressure (150/90) is also notable, especially since you typically have low blood pressure (100/50). This sudden change could be due to several factors, including anxiety, sleep apnea, or exacerbation of your lung condition. Sleep apnea, in particular, is common in individuals with lung issues and can lead to significant fluctuations in blood pressure during the night. It is crucial to discuss these symptoms with your healthcare provider, as they may recommend further evaluation, such as a sleep study or pulmonary function tests.

In summary, your condition involves multiple factors that require careful management. It is essential to maintain regular follow-ups with your healthcare provider, who can monitor your lung health, evaluate the nodules, and address your blood pressure concerns. Lifestyle modifications, such as avoiding exposure to harmful chemicals and ensuring a healthy diet, can also support your lung health. If you experience worsening symptoms or new concerns, do not hesitate to seek immediate medical attention.

Thank you for reaching out, and I wish you the best in your health journey.

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