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What Causes Breathing Difficulties And Heaviness In Chest And Legs?
Question: Hi..I am a 65 year old female having spells that cause difficulty breathing - like a weight on my chest, clammyness, limbs that feel like they weigh a ton and can't open my eyes or respond to questions. I have had stress tests that have brought on these spells but my blood pressure stays normal as well as pulse and oxygen levels. I have had ekg's, an eeg and pulmonary tests that all come back normal. I don't know where to turn. I have seen cardiologists, neurologists, pulmonologists and would appreciate any direction you can give.
Brief Answer:
I would suggest as follows:
Detailed Answer:
Hello!
Thank you for asking on HCM!
I passed carefully through your complains history, and would like to explain that your clinical scenario is a mixture of atypical symptoms (you have difficulty breathing, but with normal blood oxygen saturations; you feel like your limbs are weighting a ton, and your blood pressure remains normal on exertion; you have normal blood pressure, but you can't open your eyes, or even respond to questions??!! You have spells of dyspnea and chest weighting on stress test, but without a clear conclusion??!!).
Coming to this point, before drawing the conclusion that we have to do with a psychological functional condition (disorder), I would recommend to explore further by means of imagine tests.
I am not sure that event monitor will come to the end with a helpful conclusion, as your complains are not strongly suggestive for a certain direction (a hemodynamic disorder, an arrhythmic cause etc).
Nevertheless, we have to wait its conclusion, to rule out any possible arrhythmia implications to the matter.
A dynamic left ventricular outflow obstruction should be ruled out by cardiac imagine tests (cardiac ultrasound, etc), if not performed yet.
I would recommend to perform a perfusional stress imagine study of your heart (Cardiolite), to clearly rule out any possible ischemic myocardial disorders.
I don't know exactly the diagnostic work up performed by neurologist, but the main issues to exclude are, an atypical epilepsy, and a possible cerebrovascular disorder, as well as some degenerative cerebral disorders. (EEG, brain CT & MRI, etc, would be helpful to differentiate between them).
At the end, if everything results normal, then you need to talk with a psychiatrist to define any possible functional disorders, panic attacks, etc. responsible for your clinical scenario.
Hope to have been helpful.
Feel free to ask me whenever you need. Greetings! Dr. Iliri
I would suggest as follows:
Detailed Answer:
Hello!
Thank you for asking on HCM!
I passed carefully through your complains history, and would like to explain that your clinical scenario is a mixture of atypical symptoms (you have difficulty breathing, but with normal blood oxygen saturations; you feel like your limbs are weighting a ton, and your blood pressure remains normal on exertion; you have normal blood pressure, but you can't open your eyes, or even respond to questions??!! You have spells of dyspnea and chest weighting on stress test, but without a clear conclusion??!!).
Coming to this point, before drawing the conclusion that we have to do with a psychological functional condition (disorder), I would recommend to explore further by means of imagine tests.
I am not sure that event monitor will come to the end with a helpful conclusion, as your complains are not strongly suggestive for a certain direction (a hemodynamic disorder, an arrhythmic cause etc).
Nevertheless, we have to wait its conclusion, to rule out any possible arrhythmia implications to the matter.
A dynamic left ventricular outflow obstruction should be ruled out by cardiac imagine tests (cardiac ultrasound, etc), if not performed yet.
I would recommend to perform a perfusional stress imagine study of your heart (Cardiolite), to clearly rule out any possible ischemic myocardial disorders.
I don't know exactly the diagnostic work up performed by neurologist, but the main issues to exclude are, an atypical epilepsy, and a possible cerebrovascular disorder, as well as some degenerative cerebral disorders. (EEG, brain CT & MRI, etc, would be helpful to differentiate between them).
At the end, if everything results normal, then you need to talk with a psychiatrist to define any possible functional disorders, panic attacks, etc. responsible for your clinical scenario.
Hope to have been helpful.
Feel free to ask me whenever you need. Greetings! Dr. Iliri
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Thank you for your quick response. I have considered panic attacks but the effects of each spell last for days and they have happened when I am with friends on the golf course, just climbing stairs, cleaning up the garage - certainly not situations where I am under stress. I will return to the neurologist to get answers to your suggestions.
Brief Answer:
You are welcome!
Detailed Answer:
Hello again!
I would suggest to first take into consideration all the above mentioned options, and only after excluding them one by one (in fact a diagnosis by exclusion), to think of a possible functional disorder (including even panic attacts).
Best regards! Dr. Iliri
You are welcome!
Detailed Answer:
Hello again!
I would suggest to first take into consideration all the above mentioned options, and only after excluding them one by one (in fact a diagnosis by exclusion), to think of a possible functional disorder (including even panic attacts).
Best regards! Dr. Iliri
Note: For further queries related to coronary artery disease and prevention, click here.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
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