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Dear Helen, Parkinson Plus(MSA/Shy-Drager) refers to PD plus autonomic dysfumctions such as: urinary incontinence,constipation,unstable blood pressure characterized by orthostatic hypotension,supine hypertension,and post-prandial hypotension, control of movement,balance,lack of coordination, sexual malfunction,difficulties in speaking,rigidity,slowness due degeneration in various parts of the brain. We first learned of this syndrome from someone on the PD list whose husband had similar symptoms and for whom the MSA diagnosis had been made.When I asked her what it was,she referred me to the Shy-Drager e-mail list from which I quickly got the basics including an invitation from an MD here in Israel to do an evaluation.He is the Director of an Autonomic Dysfunction Center at Rambam Hospital in Haifa.His training on MSA was obtained at the Vanderbilt Univ. Med. Schl. in Nashville which is an MSA research center.He did an evaluation of Aliza and recommended a series of tests to confirm the MSA diagnosis.She did some of the tests but the results were not conclusive.He felt that we shouldn't bother Aliza further.It is very serious business with life-expectancy after diagnosis of five to seven years.He suggested that I not bother Aliza with the grim details. The Spring 1998 issue of the NPF Parkinson Report has a review article on MSA by the Vanderbilt Univ. group.See their web site: http://www.ndrf.org and the file: http://www.ndrf.org/MSA.htm Aliza has been experiencing shortness of breath for at least ten years;well before her PD dx in 2/95.In 1992,she complained of chest pains and had stress tests and an angiogram.She did not have any blockages and it was concluded that she has cardiac insufficiency due to a weak heart valve.As a consequence, she takes diuretics to keep her lungs clear of water and minimize water accumulation evidenced particularly by swelling of ankles and feet.She is at risk for Congestive Heart Failure(CHF)should the fluid build up.As a consequence,she is subject to severe urinary stress. Right now,she is undergoing a 24 hour heart rate halter test as part of a check-up and evaluation for a pace-maker developed here in Israel for people with cardiac insufficiency. I probably told you more than you want to know. By all means,your husband should be evaluated by a cardiologist.After her angiogram,Aliza also underwent pulmonological tests to evaluate the strength of her lungs. So see a Pulmonologist too.Aliza's breathing is also exacerbated by a bad spinal scoliosis,so she has also consulted with an orthopedist. I would be interested in what the ultimate diagnosis is of your husband. Best wishes. Gil -------------- At 4:40 PM 3/15/99 EST, you wrote: >Dear Gil: > Thank you for responding to my note on Listserv. You mentioned Parkinson >Plus, autonomic dysfunctions due to neurologic causes. Who made this diagnosis >and that is it? Also did your wife go to a cardiologist for a stress test? > > I think my husband need to see a specialist in regard to this problem.The >question is who. His shortness of breath lingers all day and all night, >although it does appear to wane once he falls asleep. > > Thanks for your input > >Helen > >