Recognizing Early ILD Symptoms Can Speed Up Diagnosis: Steven D. Nathan, MD

Delays in diagnosis and treatment for interstitial lung disease (ILD) occur quite frequently, as many of the initial symptoms, like shortness of breath or Velcro crackling, overlap with a myriad of conditions such as chronic obstructive pulmonary disease, asthma, obesity, or even heart failure.

Although there are numerous ways patients experiencing potential ILD may have delays in diagnosis, physicians must be diligent when monitoring symptoms that may precede a ILD diagnosis, Steven D, Nathan, MD, said in an interview with The American Journal of Managed Care^® (AJMC^®). Nathan is the Schar Chair of advanced lung disease and lung transplant, as well as the medical director of the advanced lung disease and lung transplant program, at Inova Schar Heart and Vascular.

“What separates the good from the great primary care providers are those [who] recognize a difference in those with interstitial lung disease,” he said. “The clues in particular are when listening to the lungs, listen for crackles at the bases, typical Velcro crackles, or what is described in [idiopathic pulmonary fibrosis], and it sounds like Velcro getting pulled apart.”

One of the most common symptoms patients at risk for ILD may present with, aside from Velcro crackles, is shortness of breath and thus should be subject to pulmonary function studies. Nathan continued to emphasize the importance of physician expertise when discussing or consulting patients with a potential ILD.

His sentiments echoed earlier conversations at the Washington, DC, Pop Health Roundtable hosted by AJMC, which focused on various aspects of clinical care and procedures for ILDs.

“It takes an astute physician or clinician to recognize that this is interstitial lung disease and not one of the other more common conditions,” Nathan said. “But if there are any doubts, then patients should be referred on to tertiary care centers, where they can try and figure it out and help to make a diagnosis.”