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Have Recurring Chest Pain With Breathing Difficulty. CT Scan Normal. What Should I Do Next?
Question: I am 35 years old. I am having recurring chest pain below my right breast that goes to the back and i feel it only when i move. My main issue is taking deep breaths. I feel i am not getting satisfactory breaths. It is like this since 3 months all the time. My doc did CT chest scan and it came out normal. I am worried about my shortness of breath. Can you please let me know what steps should i take.
Should i consider cardiological issue or pulmonology?
Should i consider cardiological issue or pulmonology?
Hi,
Thanks for posting the query on XXXXXXX After going through your query, I would like to comment the following:
1. You seem to be having right sided chest pain increased on inspiration. You also have past history of asthma.
2. If your chest xray and ct scan of thorax are normal, than most of the lung pathologies have been ruled out. Also being right sided and related to breathing, the chest pain is less likely to be associated with cardiac cause.
3. There is a possibility of sub diaphragmatic cause on the right side leading to this chest pain. Causes like gall stones need to be ruled out. Please get a sonography / ct of the abdomen done. A clinical examination by a surgeon or a gastroenterologist will help.
4 . Also sometimes dry pleurisy in the initial stages gives such clinical picture. Please also get yourself clinically evaluated by a pulmonologist and get your pulmonary function test done to see if there is some chest wall defect or merely airway obstruction of asthma.
5. In absence of any other feature like increased breathlessness or swelling of the legs a cardiac cause is less likely however an ECG/ 2d echo will help to screen any major cardiac disease.
6. Also being an asthmatic you need to have your asthma managed according to your lung function in consultation with a Pulmonologist.
I hope I have answered your query. I will be glad to answer follow up queries if any.
Please accept my answer if you have no follow up queries.
Regards
Dr. Gyanshankar Mishra
MBBS MD DNB
Consultant Pulmonologist
Thanks for posting the query on XXXXXXX After going through your query, I would like to comment the following:
1. You seem to be having right sided chest pain increased on inspiration. You also have past history of asthma.
2. If your chest xray and ct scan of thorax are normal, than most of the lung pathologies have been ruled out. Also being right sided and related to breathing, the chest pain is less likely to be associated with cardiac cause.
3. There is a possibility of sub diaphragmatic cause on the right side leading to this chest pain. Causes like gall stones need to be ruled out. Please get a sonography / ct of the abdomen done. A clinical examination by a surgeon or a gastroenterologist will help.
4 . Also sometimes dry pleurisy in the initial stages gives such clinical picture. Please also get yourself clinically evaluated by a pulmonologist and get your pulmonary function test done to see if there is some chest wall defect or merely airway obstruction of asthma.
5. In absence of any other feature like increased breathlessness or swelling of the legs a cardiac cause is less likely however an ECG/ 2d echo will help to screen any major cardiac disease.
6. Also being an asthmatic you need to have your asthma managed according to your lung function in consultation with a Pulmonologist.
I hope I have answered your query. I will be glad to answer follow up queries if any.
Please accept my answer if you have no follow up queries.
Regards
Dr. Gyanshankar Mishra
MBBS MD DNB
Consultant Pulmonologist
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Thanks a lot for the response.
I did not get a chest X-ray though. Only the CT scan. I hope that is good. My family doc actually suspected pulmanary embolism and ordered a CT scan and it came out normal.
This does not seem like my regular asthma. I had to deep breath for every 10 min and i have to do it hard. No cough at all. No cold. Or is this a diff face of asthma?
I tried using albuterol spray but no luck.
I do have gastritis. I did have an stomach ultrasound 6 months back. Do i need to do it again? And also an endoscopy an year ago.
My shortness of breath is the same all the time not much affected by excercise. I sleep fine. I dont have any shortness of breath while sleeping.
I did not get a chest X-ray though. Only the CT scan. I hope that is good. My family doc actually suspected pulmanary embolism and ordered a CT scan and it came out normal.
This does not seem like my regular asthma. I had to deep breath for every 10 min and i have to do it hard. No cough at all. No cold. Or is this a diff face of asthma?
I tried using albuterol spray but no luck.
I do have gastritis. I did have an stomach ultrasound 6 months back. Do i need to do it again? And also an endoscopy an year ago.
My shortness of breath is the same all the time not much affected by excercise. I sleep fine. I dont have any shortness of breath while sleeping.
Hi,
Thanks for the follow up query. After going through the follow up query, I would like to comment the following:
1. Your asthma does not seem to be under control. You need to get your asthmatic management titrated as per your lung function test since if the breathlessness is persisting than albuterol spray is not enough and "stepping up of therapy " is indicated. Please visit a Pulmonologist.
2. A normal ct scan of thorax is definitely a good news and it had ruled many other diagnoses in your case but pathologies below the diaphragm like gall stones do present in such a way and are not picked up by ct scan of the thorax. At least a USG abdomen needs to be repeated. Also you need to take antacid medications under supervision of your doctor.
I hope I have answered your query. I will be glad to answer follow up queries if any.
Please accept my answer if you have no follow up queries.
Regards
Dr. Gyanshankar Mishra
MBBS MD DNB
Consultant Pulmonologist
Thanks for the follow up query. After going through the follow up query, I would like to comment the following:
1. Your asthma does not seem to be under control. You need to get your asthmatic management titrated as per your lung function test since if the breathlessness is persisting than albuterol spray is not enough and "stepping up of therapy " is indicated. Please visit a Pulmonologist.
2. A normal ct scan of thorax is definitely a good news and it had ruled many other diagnoses in your case but pathologies below the diaphragm like gall stones do present in such a way and are not picked up by ct scan of the thorax. At least a USG abdomen needs to be repeated. Also you need to take antacid medications under supervision of your doctor.
I hope I have answered your query. I will be glad to answer follow up queries if any.
Please accept my answer if you have no follow up queries.
Regards
Dr. Gyanshankar Mishra
MBBS MD DNB
Consultant Pulmonologist
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Thanks a lot. You answer makes a lot of sense to me and my medical situation.
I will take an appointment with pulmanologist and Gastroentrologist.
Thanks again.
I will take an appointment with pulmanologist and Gastroentrologist.
Thanks again.
Hi,
Wish you a speedy recovery.
Regards
Dr. Gyanshankar Mishra
MBBS MD DNB
Consultant Pulmonologist
Wish you a speedy recovery.
Regards
Dr. Gyanshankar Mishra
MBBS MD DNB
Consultant Pulmonologist
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Answered by
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