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Suddenly started feeling breathing difficulty, blurred vision, hot and sweating. Worrisome

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Cardiologist
Practicing since : 1981
Answered : 922 Questions
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Hi
my name is XXXXXXX, I'm 43 male, smoker. last Thursday morning i was in a Cafe having a breakfast, cheese sandwich with orange juice. the weather was fine, i was sitting outside, and just after the third bite, i started to feel hot, then sweating a lot, and while i was sweating, i felt a bit dizzy, so i laid back on the chair, then i started to feel heaviness, or a pressure on my chest (like elephant sitting on me) at that moment i was having difficulty breathing, and while i was fighting for air, i felt my vision of surrounding was getting darker .. i thought i was dying and i remember i was leaning forward very slowly, then I'm not sure if i fainted or not, because when i got back my feeling of the surrounding i was leaning on my side, there was no more heaviness and i was breathing easily, but still sweating and feeling nausea, and when i vomited the sweating stopped and i felt better, after that i went to hospital and they did ECG, blood test, ECG with exercise, and ECCO. in the ECG my heart looks normal and my blood test was negative for the enzyme.
we have no heart disease in the family neither diabetes
we have low blood pressure in the family
my cholesterol level is 210
now, can you please explain to me what happened that day, is it my heart, or lungs or my low blood pressure.

Regards,

XXXXXXX
Posted Tue, 30 Oct 2012 in Hypertension and Heart Disease
 
 
Answered by Dr. Anil Grover 3 hours later
Hi there.
Thanks for writing in.
I am a qualified and certified cardiologist.
How much the time difference between the "attack" you have and EKG which was done? And what was your blood pressure first recorded after the "attack XXXXXXX
Your cholesterol is high what are the other fractions of it (like LDL, HDL). And if you can send your EKG I will be in better position to answer your question.
Looking forward for your reply.
Regards
With best wishes.
Dr Anil Grover,
Cardiologist
M.B.;B.S, M.D. (Internal Medicine) D.M.(Cardiology)
http://www/ WWW.WWWW.WW
Above answer was peer-reviewed by
 
Follow-up: Suddenly started feeling breathing difficulty, blurred vision, hot and sweating. Worrisome 35 hours later
EKG report attached.
 
 
Answered by Dr. Anil Grover 7 minutes later
Hi,

As there was communication lapse, let us try to analyze what might had happened on that day.

You have given three option heart, lungs or low blood pressure. And I am adding fourth that is brain.

Heart: You could have sustained acute ischemic insult but that did not lead to heart attack mainly because of two reasons:

a). You recovered on vomiting without any treatment.
b) EKG and blood tests were normal

So, the conditions left related to heart are very fast rate tachyarrhythmia or very slow bradyarrhythmia or possibly rest angina (unstable angina).

Lungs: As you have not told us about any previous lung illness. You (I assume as normal sleep) so you could not be suffering from sleep apnoea syndrome or lung disease.

Low Blood Pressure with autonomic neuropathy can produce such symptoms but those are like fainting attacks not associated with pressure on chest.

So, in my opinion as provisional diagnosis we ought to consider Transient Ischemic Attack with Temporal Lobe Epilepsy like features or Unstable Angina. Both need further examination and investigations.

Good Luck.
Above answer was peer-reviewed by
 
Follow-up: Suddenly started feeling breathing difficulty, blurred vision, hot and sweating. Worrisome 5 minutes later
Hi
the "attack" was between 10:00 to 10:30 morning and the first EKG was taken around 12:58 afternoon same day, so I guess two and a half hour.
and for my blood pressure, I saw two reading in my file, one was 96 - 64 and the other was 102 - 61 that day.
and for the Cholesterol, LDL 139 , HDL 56 , TRIG 75
as far the EKG I have a copy of the first one, but I don't know how to send it to you?

By the way, that day I had smoked 2 cigarettes and usually I don't smoke that early.

Regards,

XXXXXXX
 
 
Answered by Dr. Anil Grover 1 hour later
Hello XXXXXXX,

Thanks for writing back.
Your EKG being normal with normal blood tests takes us away from Unstable Angina or Coronary Artery Disease.
Your Cholesterol components are all within normal limits. Smoking is the only risk factor remains. Please try to curtail as much as possible.

Now we are left with some acute self correcting illness which produced pressure on your chest and recovered without treatment. You had written about sweating so shift of fluids (aided further by vomiting) thus volume out of blood vessels can aggravate hypotension. This can cause decreased flow of blood to brain and heart and all the symptoms (before self preservative mechanisms, which are auto regulatory, set in) can be produced- in the manner you have described.
Therefore, what I will suggest is (apart from curtailing smoking) keep yourself well hydrated. Wear crape bandages on legs(or tight stockings) if your job or any activity involves long standing posture. Do simple exercises like brisk walking. If you have any more question I will be pleased to answer. EKG you can upload in WWW.WWWW.WW or send to email YYYY@YYYY
Regards
With best wishes.
Dr Anil Grover,
Cardiologist
M.B.;B.S, M.D. (Internal Medicine) D.M.(Cardiology)
http://www/ WWW.WWWW.WW
Above answer was peer-reviewed by
 
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