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What Causes Shortness Of Breath Along With Metallic Taste In Mouth?
Question: Past medical History - I have quadriparesis, idiopathic progressive poly-peripheral neuropathy, idiopathic progressive autonomic neuropathy, RIND stroke survivor, visually impaired, hearing impaired, restrictive airway disease 5 Liters oxygen dependent with an elevated diaphragm on the left side, obstructive airway disease, asthma, diabetes type 2 on insulin, hypothyroid, goyder, adrenal gland insufficiency, addison's crisis, hypotension, primary hypertension, atrial flutter (corrected by ablation), gastroparesis, irritable bowel syndrome.
Currently, I am a 47 year old Female, weighing 296 lbs (barley eating but still heavy on hydrocortisone)
I am experiencing shortness of breath, with a very metallic taste in my mouth (as if aluminum foil was in my mouth), when I move to transfer to my wheelchair I am extremely short of breath that it causes me very bad pain in my chest, however when I stop my movement, rest, and catch my breath my pain stops.
A few months ago I had a angiogram and EP study which were normal after I had similar symptoms but less severe.
I am using a nebulizer and cortisone with some improvement, but I would like not to struggle to breathe. Please give me advice. Thank you very much. Also, my disease process is undiagnosed and I am awaiting whole exome sequencing.
Currently, I am a 47 year old Female, weighing 296 lbs (barley eating but still heavy on hydrocortisone)
I am experiencing shortness of breath, with a very metallic taste in my mouth (as if aluminum foil was in my mouth), when I move to transfer to my wheelchair I am extremely short of breath that it causes me very bad pain in my chest, however when I stop my movement, rest, and catch my breath my pain stops.
A few months ago I had a angiogram and EP study which were normal after I had similar symptoms but less severe.
I am using a nebulizer and cortisone with some improvement, but I would like not to struggle to breathe. Please give me advice. Thank you very much. Also, my disease process is undiagnosed and I am awaiting whole exome sequencing.
Brief Answer:
get done CT pulmonary angiography.
Detailed Answer:
Hello dear, thanks for your question on HCM.
I can understand your situation and problem.
Since your recent cardiac work up is normal,no need to worry for cardiac cause for your present symptoms.
In my opinion following are the possibilities in your case for your extreme shortness of breath even on mild exertion.
1. Worsening of underlying asthma.
Prolonged oral steroid use cause worsening of underlying asthma. It actually produce steroid resistant state. Your nebulizer (duoneb) is also not containing steroid. Ideally in asthma inhaled corticosteroids(ICS) must be given as they are the first line treatment for asthma. Oral steroids are very dangerous in long term use as they can cause diabetes and hypertension. So ICS are much more safer and preferred and should be started in your case.
2. Pulmonary embolism.
You have many risk factors for pulmonary embolism including obesity,quadriparesis,bedridden state,diabetes,hypertension, atrial flutter etc. And chest pain with extreme shortness of breath is seen in pulmonary embolism. So this must be rule out in your case. Get done CT pulmonary angiography to rule out pulmonary embolism.
3. Hypoxia (low oxygen level)
Due worsening of underlying restrictive lung disease even with 5 liters of oxygen you may have low oxygen levels which aggravate shortness of breath. So get done ABG (arterial blood gas) analysis.
Consult pulmonologist and discuss all these possibilities.
Hope I have solved your query.
I will be happy to help you further.
Wish you good health.
Thanks.
get done CT pulmonary angiography.
Detailed Answer:
Hello dear, thanks for your question on HCM.
I can understand your situation and problem.
Since your recent cardiac work up is normal,no need to worry for cardiac cause for your present symptoms.
In my opinion following are the possibilities in your case for your extreme shortness of breath even on mild exertion.
1. Worsening of underlying asthma.
Prolonged oral steroid use cause worsening of underlying asthma. It actually produce steroid resistant state. Your nebulizer (duoneb) is also not containing steroid. Ideally in asthma inhaled corticosteroids(ICS) must be given as they are the first line treatment for asthma. Oral steroids are very dangerous in long term use as they can cause diabetes and hypertension. So ICS are much more safer and preferred and should be started in your case.
2. Pulmonary embolism.
You have many risk factors for pulmonary embolism including obesity,quadriparesis,bedridden state,diabetes,hypertension, atrial flutter etc. And chest pain with extreme shortness of breath is seen in pulmonary embolism. So this must be rule out in your case. Get done CT pulmonary angiography to rule out pulmonary embolism.
3. Hypoxia (low oxygen level)
Due worsening of underlying restrictive lung disease even with 5 liters of oxygen you may have low oxygen levels which aggravate shortness of breath. So get done ABG (arterial blood gas) analysis.
Consult pulmonologist and discuss all these possibilities.
Hope I have solved your query.
I will be happy to help you further.
Wish you good health.
Thanks.
Above answer was peer-reviewed by :
Dr. Yogesh D
I have some PULMICORT RESPULES (budesonide inhalation suspension). Would it help to rule out my asthma? Also, I am on plavix could I still have a pulmonary embolism? I just checked my SpO2 is 93 to 95. Also, I unfortunately need to take hydrocortisone daily secondary to my adrenal gland insufficiency and past addison's crisis.
Brief Answer:
need to know few things.
Detailed Answer:
Hello dear,thanks for your follow up question.
I want to ask few questions first.
1. Your oxygen saturation of 92-95 is with room air or with 5 liters of oxygen?
2. You are taking plavix in which dose?
Please reply these questions ,so that I can guide you better.
I will be happy to help you further.
Wish you good health.
Thanks.
need to know few things.
Detailed Answer:
Hello dear,thanks for your follow up question.
I want to ask few questions first.
1. Your oxygen saturation of 92-95 is with room air or with 5 liters of oxygen?
2. You are taking plavix in which dose?
Please reply these questions ,so that I can guide you better.
I will be happy to help you further.
Wish you good health.
Thanks.
Above answer was peer-reviewed by :
Dr. Shanthi.E
My oxygen saturation is on 5 Liters Oxygen and I take Plavix 75 mg.
Brief Answer:
consult pulmonologist.
Detailed Answer:
Hello dear, thanks for your question on HCM.
Pulmonary embolism can be seen in patients taking blood thinners, if risk factors are present.
So possibility of pulmonary embolism can not be denied in your case.
And Saturation of 92-93 with 5 liters of oxygen is also considered as low. So this can be due to worsening of underlying asthma or restrictive lung disease.
Better to consult pulmonologist and get done clinical examination and discuss all these with him.
Hope I have solved your query.
I will be happy to help you further.
Wish you good health.
You can ask me directly on bit.ly/askdrkaushalbhavsar.
Thanks.
consult pulmonologist.
Detailed Answer:
Hello dear, thanks for your question on HCM.
Pulmonary embolism can be seen in patients taking blood thinners, if risk factors are present.
So possibility of pulmonary embolism can not be denied in your case.
And Saturation of 92-93 with 5 liters of oxygen is also considered as low. So this can be due to worsening of underlying asthma or restrictive lung disease.
Better to consult pulmonologist and get done clinical examination and discuss all these with him.
Hope I have solved your query.
I will be happy to help you further.
Wish you good health.
You can ask me directly on bit.ly/askdrkaushalbhavsar.
Thanks.
Above answer was peer-reviewed by :
Dr. Vaishalee Punj
I had a feeling that what I was experiencing was both of what you you said. When you mentioned that this might be my asthma and my restrictive airway disease I felt you were on target. Also, it would not hurt to get a CT pulmonary angiogram to rule out a pulmonary embolism. Last night I passed out and had trouble remembering a half hour of events. After I woke up, I had my husband raise my oxygen and I started to feel better and remember what happened. I spoke with my doctor and he agrees with you. I will be seeing him soon. Thank you for your help. I will let you know what happens.
Brief Answer:
I will be happy to get feedback from you.
Detailed Answer:
Hello dear, thanks for your follow up question.
And thanks for the kind words. I am truely obliged.
And I will definitely like to hear your prognosis.
So do let me know. Its always encouraging for doctor.
Hope I have solved your queries.
If you are not having further queries than please close the conversation and rate the answer.
Wish you good health.
You can also contact me directly by bit.ly/askdrkaushalbhavsar.
Thanks.
I will be happy to get feedback from you.
Detailed Answer:
Hello dear, thanks for your follow up question.
And thanks for the kind words. I am truely obliged.
And I will definitely like to hear your prognosis.
So do let me know. Its always encouraging for doctor.
Hope I have solved your queries.
If you are not having further queries than please close the conversation and rate the answer.
Wish you good health.
You can also contact me directly by bit.ly/askdrkaushalbhavsar.
Thanks.
Above answer was peer-reviewed by :
Dr. Shanthi.E
Answered by
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