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Suffering from cough and shortness of breath. Blood work done. What is going on?

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Pediatrician, Infectious Diseases
Practicing since : 2005
Answered : 1528 Questions
Hi. I went to the ER this morning BC of tachycardia (130+) and high RR. I have had an interestingtwo weeks that began with a cross country road trip for a wedding, gained severe bilateral ear infections and a sinus infection. For those an urgent care Rxd a tapered high dose steroid, amoxicillin TID, and vicodin pen. I completed th course of steroid and antibiotic on Wed. Thursday this past week a non productive cough developed. Friday the car trunk lid cracked me on the head. The cough became worse, headache ensued, and my rehab Mgr sent me home (I am a therapist at a hospital). Today I woke up with the cough, the elevated heart rate and SOB. The ER said all my blood work was normal except for an elevated d'dimer (they didn't give me the number) but gave me three albuteroltx, solumedrol via IV. CT came back negative, not anemic, wbc nL. They Dxd bronchitis and esophagitis. I take cymbalta 60mg qd and the nuva ring prophylactically. My mom has ITP, and when I had a choleycystectomy last spring they found pre-CA cells that the MD assured me he removed. I am a recovering smoker. That is a brief PMH. What is going on, any ideas? My husband is gone so I am just wondering if I need to go back to the ER, Thanks so much
Posted Wed, 7 Nov 2012 in General Health
Answered by Dr. Hema Yadav 3 hours later
Thanks for posting your query.
I appreciate the details you have provided and considering them the most probable cause for your cough and shortness of breath does seem to be a bronchitis which can in turn cause tachycardia as well.
Another cause could be a pulmonary thromboembolism especially if d dimer levels are high , however I assume your ER doctors would have ruled that out by a normal xray & CT Scan test.
Most people that present with Pulmonary Embolisms do have a sudden onset of shortness of breath, they also have chest pain associated with breathing. They generally have a faster than normal heart rate and a low oxygen saturation level.
A D-Dimer is an assay test they use to determine your risk for blood clots. A positive D-Dimer does not always mean a blot clot. D- Dimers will be positive from inflammation/swelling, liver disease, trauma, Rheumatoid Factor and Cancers too.
However since you have had a long journey , had a history of smoking and on birth control pills there is an increased risk for getting blood clots or thromboembolism .
Esophagitis or acid reflux can also cause cough , breathing difficulty and like any inflammation a marginally raised d dimer however you should be having some relief if the doctor has put you on any antacids or pantoprazole etc( acid blockers)

To sum it up your findings do seem minor but since you are at risk of a pulmonary thromboembolism which is a condition likely to be missed in initial stages I would recommend you consult the ER or preferably a pulmonologist who can reevaluate you and rule out any serious cause .
It's better to get examined and investigated right away than waiting for the symptoms to progress so in case you can't secure an early appointment with your pulmonologist do visit the ER again .
Hope I have answered your query.
I'll be available for any follow up queries.

Above answer was peer-reviewed by
Follow-up: Suffering from cough and shortness of breath. Blood work done. What is going on? 23 minutes later
CT scan for PE was negative. Could the d'dimer have been elevated from all the inflamation and infections?
Answered by Dr. Hema Yadav 8 minutes later
Thanks for the follow up.
Yes , in that case the d dimer could be raised by inflammation or infection ( bronchitis , esophagitis etc).
But you need to take medications to control them . If you have finished the course of antibiotics it's advisable to get prescribed supportive medications like antiinflammatory analgesics ( acetaminophen , ibuprofen ) bronchodilators ( inhaled or oral salbutamol ) and cough suppressants or antihistamine medications for your present symptoms . If you can visit your GP or a pulmonologist for the same within a day or so it would be fine .
However if its going to take more than a couple of days for appointment do visit the ER .

Hope that answers your query.
Kindly accept my answer if you have no further queries.
Above answer was peer-reviewed by
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