Has anyone with COPD who hasn't been on assisted respiration developed respiratory alkalosis?

I have pectus excavatum and COPD. I have flared lower ribs which make the depressed sternum even more pronounced, but which also gave me a large 5.25 litre lung capacity. The average is about 4.5 L and pectus excavatum can often reduce lung capacity. I started getting breathless lying in bed a couple of years ago at 54 years old and had a chest x-ray that showed COPD. My blood oxygenation had decreased a couple of percent from its normal high of 100% to 96% so was still within 'normal' range and my spirometry reading showed only mild stage 1 COPD so my doctor wasn't that concerned. A couple of months ago I started to get arrhythmia and had a number of tests. The chest x-ray showed the bronchitis is very chronic and widespread and the CT scan showed the emphysema is also chronic and widespread, and going by the scans my doctor has now reclassified me as category 3 COPD. My blood oxygen sits around 91 to 93% at rest but has been as low as 87%. I just had a nocturnal oxygen diffusion test to see how low it drops when I'm sleeping and if I need oxygen at night. It made me consider that possibly the spirometry readings aren't accurate if you have increased or decreased lung capacity due to pectus excavatum. Does anyone have a similar experience? The echocardiogram also showed my sternum is indenting on my right ventricle due to the pectus excavatum, though there doesn't seem to by any physical heart changes except for moderate calcification of the coronary arteries. Apparently some people with pectus excavatum have no symptoms until they are over 50 as before that there chest wall is elastic enough for the heart to move out of the way of the sternum but after around 50 they start to get breathlessness, fatigue and arrhythmia. It's called Symptomatic Pectus Excavatum in Seniors (SPES) and not all radiologists and cardiologists are familiar with it as the research is still quite new and limited. I'm considering a Nuss Procedure but that isn't the only cause of my heart problems. I keep reading how COPD effects the heart and can cause right ventricular damage and is linked to athosclerosis due to the systemic inflammation it produces but can't find anything on heart conduction issues. Apparently my arrhythmia is due to a partial right branch block and a full left posterior fascicular block causing bradycardia, and atrial systole(s) causing tachycardia. Does anyone else with COPD have heart conduction issues, in particular a left posterior fascicular block? My other problem is my phosphate levels have suddenly dropped and my blood pH has risen and now I have alkalosis (venous blood pH 7.45) and hypophosphataemia (phosphate at 7.4 mmol/L). I have asked my doctor a couple of times if I could have respiratory alkalosis but he doesn't think so, but finally has referred me to a lung specialist who should be able to organise an arterial gas exchange test which will confirm or deny if it's respiratory alkalosis. I have come across a fair bit of research on respiratory alkalosis in COPD sufferers, and it seems about half of advanced cases of COPD having respiratory alkalosis and the other half respiratory acidosis. It does seem that those put on assisted ventilation can develop respiratory alkalosis, but I can't find if it can naturally develop in advanced COPD sufferers who aren't on assisted ventilation. Has there anyone out there with COPD who hasn't been on assisted ventilation developed respiratory alkalosis? I've been wondering if this is common or just due to my larger than average lung capacity due to my pectus excavatum. I've given up the pursed lips breathing and have been trying to increase the length of time between breaths and the tachycardia has improved slightly but don't know if I'm retaining too much carbon dioxide or expelling too much. I wish you could measure carbon dioxide levels in the blood add easily add oxygen levels. On that issue I read that fingertip pulse oximeter readings can give up to 4% higher oxygen reading than is accurate with COPD sufferers so my oxygen may be in the high 80s instead of the low 90s. Has anyone had much higher oxygen levels with a pulse oximeter as opposed to an arterial gas exchange test? Thanks to anyone who can help with any over the questions in this long rave. I'm having trouble getting straight answers from the medical profession and the cardiologist at the local hospital hadn't heard of SPES or the link between COPD and coronary issues. He did organise an angiogram to see how bad the calcification is, which hopefully will happen withing the next 3 to 4 weeks. I'm taking 15mg vitamin K tablets to try to reduce the calcification as it cut coronary artery calcification in rats by up to 44% in just six weeks. Anyway, please respond if you have had a similar experience. I'm especially interested in anyone else with both COPD and pectus excavatum, and anyone with COPD who hasn't been on oxygen or assisted ventilation but has developed respiratory alkalosis. Thank you.

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