New Program Helping Doctors Pinpoint Source Of Patients' Breathing Problems

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PITTSBURGH (KDKA) -- A new program at UPMC is now helping patients find out what's causing their undiagnosed breathing troubles, and making sure they get the right treatment.

Pittsburgh is just one of a few cities nationwide that has the program.

"I was diagnosed with cystic fibrosis when I was 6-months-old," patient Tarra Felsing said.

Felsing feels lucky she had no hospitalizations until four years ago. Her symptoms then were sudden and disabling. The cystic fibrosis had damaged her lungs.

"I could barely go up and down steps, there's no way I'd be able to take care of dogs, I could barely take care of myself," said Felsing. "I was on oxygen 24/7."

But Felsing also had another problem, the blood pressure in her lungs was too high. But were her symptoms because of the cystic fibrosis or the pulmonary hypertension?

It was hard to tell because her symptoms came on when she was active. But chest x-rays, heart ultrasounds and lung function tests -- the standard evaluations -- are done at rest. And they can be normal at rest, even if there is a problem.

So doctors are doing something new called Invasive Cardiopulmonary Exercise Testing. It helps doctors pinpoint whether the lungs, the heart, the muscles, or the blood vessels are causing the trouble.

"We've seen patients get diagnosed and change their treatment course because of these studies," said Dr. Mike Risbano, a UPMC lung specialist.

For the testing, patients will have a catheter inserted through the neck that goes into the right side of the heart. They also have lines placed for checking oxygen and carbon dioxide in the blood. The mouthpiece is for checking gas levels breathed in and out.

"The technology has existed for quite some time. This is really just a marriage of a number of different studies," said Dr. Risbano.

For that reason, it is covered by insurance. But it's not available everywhere. Just in Pittsburgh and a few other centers across the country.

"I think there's been a slow acceptance to starting to exercise-challenge patients when they come in," Dr. Risbano said.

People tolerate the few minutes of exercise well, as long as they know how.

"So we've had a couple cases where people can't ride a bicycle," he said.

In Felsing's case, the doctors were able to figure out it was her cystic fibrosis that was the bigger problem, and she got a lung transplant. She is thankful she was able to get the exercise test to sort out her issues.

"Something that I think should be in a lot of places to help a lot of people," she said.