Shortness of breath and PsA

Hi all. Over the last few months, I’ve found myself a bit short of breath. Not bad, but enough to get me to the doctor to get checked out bearing in mind my brother recently had a quadruple heart bypass, and my Mum has heart failure. I was a bit thrown when he said I need a chest x-ray to rule out fybrosis - not least because the shortage of breath only happens in certain situations, and will disappear completely for weeks or months at a time. Now, of course, I’m panicking. I was worried it might be my heart, not my lungs - and not something that can progress quite quickly. He did say he thinks the x-ray will be clear, but that doesn’t help my bipolar deal with the possibility of it.

It generally happens when I’m bending down (or, rather, just after bending down), and when I’m walking and talking at the same time. Most of the time, it’s not there at all - although of course it is now as I’m thinking about it. All the time!

I was quite surprised that the GP’s first thought was fibrosis on presentation of mildly out of breath on some occasions - especially when I’m overweight and not particularly active because of PsA. What’s more, I had a similar thing about ten years ago - just after I got diagnosed with PsA. On that occasion it lasted a few months and then vanished. It sounds weird, but his move towards fibrosis as an instinctive thing almost made me think he’d missed a case at some point and was never going to do so again. That sounds really weird, I know. I really did expect him to say “it’s possibly pollen as you’ve had it before - here’s an inhaler and come back if it doesn’t clear up.” That’s normally his way - try something simple before anything else.

I sing jazz every Monday in quite a traditional manner - so, with long drawn-out phrases with one breath - and I don’t notice at all, which doesn’t make sense to me if it’s actually lung damage.

I don’t drink or smoke or use drugs. never have - all the good that’s done my health! I feel I should just start living like Peter Stringfellow and see if my health improves in the coming years!!

My gut reaction is that it’s related to GERD more than anything else. I’ve got a flare-up of that at the moment, and also a worsening of the breathing thing - although I’ve just been bending down to fill up the washing machine and nothing happened.

But the doc mentioning fibrosis has had me panicking and Googling…and panicking…and googling…and a bit more googling. Apart from the awful prognosis of it (if I have it), the med sites can’t seem to make their mind up if there’s actually a link with PsA in the first place, because psoriasis is apparently linked to people who smoke, or smoked - therefore lung damage can be done before the disease even starts.

I’ve done a search of the forum and can’t find any threads where someone has ongoing fibrosis - which seems a bit odd if it’s linked to PsA or biologics, as many of us here have advanced PsA.

Does anyone out there have the shortness of breath thing - or, indeed, fibrosis. My 40s have been really crap, and I really don’t want to turn 50 next year with something new to worry about!

I hope you are all well - or as well as we get, at least.

GERD issues can certainly cause breathing issues and I think that instinct of yours might be correct. More so given it happens only sometimes and especially when you’re bending down which also makes GERD happen too. Your GP is probably now kicking himself for mentioning fibrosis to you, given I imagine he’s aware of how you might react.

There are some links with fibrosis and mxt I believe too. But since mxt really hated me and I never stayed on it long enough, I’ve never bothered to research that as I haven’t needed to. There are no discernable links I believe between biologics and fibrosis though.

But I would go with your GP’s attitude that the x-ray is most likely to be clear.

I’m a life long asthma sufferer and the fact that you sing regularly is one of the best things for any lung issues, just anyway.

I appreciate that none of what I’m saying is going to help you really but I do try my hardest to only worry about what I know and not anticipate anything too much. PsA can throw up enough anomalies just on its own so for me it’s a waste of time to worry about all the what if’s as having the best day I can have today is all that matters really regardless of what might be going on in the background.

Thanks, Poo. I hope you are doing well. Deep down, I think I know that it isn’t what the doctor is worried about. There appear to be possibly links between some biologics and fibrosis/lung disease, but they appear to be tenuous from what I read, and no study appears to have definitively proven it.

I woke up with the tightness and breathing issue this morning, but it’s warn off during the day, which again would make me think of GERD, as the acid can sit in your tubes during the night (I write “tubes” as I can’t spell osoph…oesoph… you know what I mean!). I know I had a spell like this in 2013 and 2015 - something else that happened at the time keeps the dates in my mind. So, I’m just hoping it’s going to go away!

I’ve had two different breathing issues since being diagnosed. One was asthma. I initially assumed that it was arthritis related and so I held off on doing anything but I did finally mention it to my rheumatologist and I got worked up by the pulmonologist and it was asthma which is now very well controlled. The other issue that I developed was ultimately diagnosed as pericarditis but I did have shortness of breath with it and pain with it.

Notice neither one causes permanent damage of any sort

Thanks Stoney. I could cope with those if I need to, I guess! Tbh, I don’t know how much is actually shortage of breath, and how much is in my head once I get the idea that I’m short of breath occasionally and it buzzes around my brain!

I know stress can do it, too, and this has been a b***dy rotten year, from a three month battle to get Mum (she’s 88) a phone line that actually works properly through to Covid, moving out while a wet room was put in my bathroom, and the DWP being an utter pain in the backside. And then very nearly a trip to A&E on Tuesday! The delights of 2023!

I’ve just been planning a birthday bash for my 50th birthday next year. But I keep telling people it’s not a 50th birthday party, it’s a “thank heaven my 40s are over party!”


When I’ve panicked about lung issues in the past, my rheumy has shown me research that Methotrexate causing pulmonary fibrosis is very very rare, and even then, questionable “causation”. I’m on Mtx, I don’t know if you are.

Sorry for the delay in replying. I’m not on MTX, but am on biologics - which also appears to have questionable links that haven’t yet been verified. I have my chest x-ray on weds, so I’m guessing we’ll find out soon!

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@darinfan how have you been doing? Did you have any follow up tests or imaging done?

Hey. I had the x-ray on Weds last week and now waiting on the results. I think I know deep down that it will be fine, but the bipolar gets me obsessing over such things.

On the plus side, this episode has got me more active than I have been since the time of the first lockdown. I’m making sure I go for walks most days, and even been doing daily exercises, and got my little weights out from under the bed and using them while waiting for the kettle to boil etc.

As for the breathing thing, the more I monitor when it occurs, the more it looks like it’s reflux/gerd related. If I woke up with reflux during the night, my chest seems tighter the next morning - and often it wears off somewhat during the day. I don’t think any breathing issues caused by something like scarring (which the x-ray was for) would come and go. That doesn’t make sense to me.

Tbh, the only reason I went to the doc in the first place was because of the heart issues that run in the family - to be on the safe side. The thought it might be lung related didn’t even cross my mind, not least because I know my breath control when singing isn’t affected at all.

But now it’s just a case of waiting for the results, and hoping my thought processes in the above comments are as logical as I am trying the convince myself they are!

Thanks for asking, Stoney, it’s very kind of you to think of me.

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Concern about heart issues should always be looked into. Rule out the big bad stuff, and then test for the other stuff. Hopefully you’re right and it’s as simple as gerd

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Thanks. I just walked back from the Monday jazz night - which isn’t all that far but has a steep hill. I was absolutely fine doing that, no breathing issues, and have been for the last week while going for walks etc. I’ll just be glad when the results are back and I can relax again!

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I just thought I should return and say that the chest x-ray came back clear a week or so ago.

The breathing issue has been fine for several weeks, and so hopefully that’s the end of it - or it’s linked to reflux, which was my initial reaction. That said, something odd happened on Thursday night. I’d taken all my nightly meds and was reading before going to bed, and I looked up from the book, and suddenly my heart began to race. My pulse was 123 at that point, although it dropped to 105ish after a few minutes. have to say it rather put the wind up me. I’ve had something like that just before bed on occasions before, but it’s always stayed under 100 bpm (as far as I know). I went to lie down on the bed and nodded off, waking about 15 minutes later, and it was down into the 90s. Then I nodded off again and woke up the next morning when it was 60-odd, and has remained thereabouts ever since.

However, I was really tired all of last week. I’m on a kind of deadline for the book I’m writing, and everything that could go wrong last week went wrong. The laptop played silly devils, then the manuscript wouldn’t upload to the website, then I couldn’t order proofs for some reason. I was really quite exasperated. And then, on Thursday evening, I had IBS pains, and so didn’t have a proper meal, even though the pains came to nothing. And I’m pretty sure I had forgotten my beta-blocker that morning, which I have for anxiety. It’s the one tablet I occasionally forget if my morning routine is interrupted. As long as I wake up, have a shower, and then make a cup of tea, all is well. But if the postman knocks, or something like that, then I have to quickly get dressed and my routine goes to pot.
So, there are plenty of things last week that could have caused it, but these things do make me nervous.

And then, just to add to things, on Friday morning rheumatology rang me to see if I wanted to see my consultant on Tuesday. Nothing to worry about there, but I just feel I need a couple of weeks to just chill, with no “bumps in the road.” It’s been a crappy year in that respect, and I just feel worn out!

Sorry for the monologue…but better out than in!