Ischemic heart disease as a factor for hindering diagnosis of idiopathic pulmonary fibrosis

UNLABELLED: The aim of the study was to find factors that may influence diagnostic process of idiopathic pulmonary fibrosis (IPF). Clinical presentation, lung function data and radiological changes were assessed in 57 patients with diagnosis of IPF. There were 25 females and 32 males in the study group; mean age was 61.4 +/- 10.9 years. Mean duration of symptoms in the whole group was 18.4 +/- 16.0 months. The most common symptoms were dyspnea on exertion (96.5% of cases) and cough (84.2% of cases). 56 out of 57 patients (98.2% of cases) had crackles on ausculation of the lungs. In one third of the patients clubbing of the fingers was found. Mean FVC% of predicted was 77.2 +/- 19.8%, and mean DLCO% of predicted was 61.6 +/- 16.8%. The most common associated disease was ischemic heart disease, found in 43.9% of patients. Duration of symptoms in patients with ischemic heart disease was 25.7 +/- 18.8 months and was as twice long as in the rest of the patients, 12.8 +/- 10.5 months (p < 0.005). CONCLUSIONS: 1: Associated ischemic heart disease may cause delay in establishing the diagnosis of IPF; 2. Crackles on ausculation are characteristic for IPF and together with disseminated changes on chest radiograms indicate correct diagnosis in patients with associated ischemic heart disease.