Kaiser Lim, MD, James T. Li, MD, PhD

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Presentation transcript:

Exertional dyspnea and inspiratory stridor of 2 years’ duration: A tale of 2 wheezes Kaiser Lim, MD, James T. Li, MD, PhD Journal of Allergy and Clinical Immunology Volume 128, Issue 5, Pages 1135-1136.e10 (November 2011) DOI: 10.1016/j.jaci.2011.09.021 Copyright © 2011 American Academy of Allergy, Asthma & Immunology Terms and Conditions

Fig E1 Baseline spirometric and methacholine challenge test results and maximal respiratory pressures. BMI, Body mass index; FEFmax, maximal forced expiratory flow; FEF25-75, forced expiratory flow at 25% to 75% of forced vital capacity; FIFmax, maximal forced inspiratory flow; Ht, height; MVV, maximal voluntary ventilation; PEmax, maximal expiratory pressure; PImax, maximal inspiratory pressure; Wt, weight. Journal of Allergy and Clinical Immunology 2011 128, 1135-1136.e10DOI: (10.1016/j.jaci.2011.09.021) Copyright © 2011 American Academy of Allergy, Asthma & Immunology Terms and Conditions

Fig E2 Inspiratory and expiratory flow-volume curves at baseline. The patient had difficulty performing the maneuvers with a forced expiratory time (FET) of less than 6 seconds. Journal of Allergy and Clinical Immunology 2011 128, 1135-1136.e10DOI: (10.1016/j.jaci.2011.09.021) Copyright © 2011 American Academy of Allergy, Asthma & Immunology Terms and Conditions

Fig E3 Maximal cardiopulmonary exercise test results performed with a bicycle ergometer, with data on the far right expressed as a percentage of the predicted maximal value. Values of greater than 85% are considered within acceptable physiologic limits. BMI, Body mass index; BSA, body surface area; Ht, height; MVV, maximal voluntary ventilation; SpO2, pulse oximetry; Ti/Ttot, inspiratory time over total respiratory cycle time; Wt, weight. Journal of Allergy and Clinical Immunology 2011 128, 1135-1136.e10DOI: (10.1016/j.jaci.2011.09.021) Copyright © 2011 American Academy of Allergy, Asthma & Immunology Terms and Conditions

Fig E4 Exercise flow-volume loops at different work intensities: at rest, at 100 W, and at 180 W without interpretations. Journal of Allergy and Clinical Immunology 2011 128, 1135-1136.e10DOI: (10.1016/j.jaci.2011.09.021) Copyright © 2011 American Academy of Allergy, Asthma & Immunology Terms and Conditions

Fig E5 Exercise flow-volume loops at different work intensities: A, Maximal Flow Volume Loop; B, at rest; C, at 100 Watts; D, at peak exercise. E, Composite overlay of A, B, C, D with interpretations. Journal of Allergy and Clinical Immunology 2011 128, 1135-1136.e10DOI: (10.1016/j.jaci.2011.09.021) Copyright © 2011 American Academy of Allergy, Asthma & Immunology Terms and Conditions

Fig E6 Pre-exercise and postexercise spirometry. The improvement in baseline spirometric results is due to increased familiarity with the maneuvers with repeated testing. There were no interim medication changes. BMI, Body mass index; FEFmax, maximal forced expiratory flow; FEF25-75, forced expiratory flow at 25% to 75% of forced vital capacity; Ht, height; Wt, weight. Journal of Allergy and Clinical Immunology 2011 128, 1135-1136.e10DOI: (10.1016/j.jaci.2011.09.021) Copyright © 2011 American Academy of Allergy, Asthma & Immunology Terms and Conditions