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What Causes Shortness Of Breath And Chest Pain Despite A Normal ECG?

Posted on Wed, 19 Oct 2016

Question: I saw a vascular surgeon after complication in my wrist, problem can be seen/read in the pdf attached (chat with doctor). I did not start the treatment for 2 days since i was busy but a Day before yesterday I was coming back from a road trip. My chest started paining a lot. On the left side both front and back same areas. I was rushed to a hospital where ecg was done. Pulse, ecg, BP all were normal, he said it was a muscular pain.Thereafter I started having problems with breathing. I was feeling shortness of breath. I didnt give attention to it thinking that it will be ok. But today shortness was unbearable and some red patches came out just below the left breast muscle also I started coughing (which was clear). I was rushed again, doctors said it might be allergy/ECG marks on chest. I am worried since I know my vascular history and I fear if it is pulmonary embolism or sort? Please help

Answered by Dr. Drkaushal85 (6 hours later)

Brief Answer:
Get done D dimer test.

Detailed Answer:
Thanks for your question on Healthcare Magic.
I can understand your concern.. I have gone through the attachment you have provided.
Yes, by your history and description, possibility of pulmonary embolism is more.
D dimer estimation is the screening test for pulmonary embolism.
So get done D dimer test.
If this is negative then no need to worry for pulmonary embolism.
Ecg changes also suggest pulmonary embolism.
So it will be of great help if you send me ecg images.
I will be happy to help you further. Wish you good health. Thanks.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Drkaushal85 (21 minutes later)

Please find attached the ECG done the day i got chest pain.
Also please let me know if it requires urgent medical attention/ it is risky?
Because i ll be doing the test tomorrow

Answered by Dr. Drkaushal85 (3 minutes later)

Brief Answer:
No need to worry much.

Detailed Answer:
Thanks for your follow up question on Healthcare Magic.
I can understand your concern.
I have gone through the ecg images you have attached.
No need to worry for pulmonary embolism.
But better to get done D dimer test to remove fear.
Please let me know
1. Do you still have chest pain and breathlessness?

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Drkaushal85 (3 minutes later)

Thank you so much doctor,
No i dont have pain anymore, but a little breathlessness. But its not unbearable but obviously uncomfortable.
Please suggest further.

Answered by Dr. Drkaushal85 (1 minute later)

Brief Answer:
I want to ask few more questions.

Detailed Answer:
Thanks for your follow up question on Healthcare Magic.
I don't think you are having pulmonary embolism.
I want to ask you few more questions only if you allow.
So may I?

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Drkaushal85 (0 minute later)

Yes sir

Answered by Dr. Drkaushal85 (1 minute later)

Brief Answer:
Do you smoke?

Detailed Answer:
Thanks for your follow up question on Healthcare Magic.
Thanks for your permission.
Please let me know
1. Do you smoke?
2. Do you have blood in sputum?
3. Do you have any lung related diseases in the past?
Please reply me answers of above asked 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. Chakravarthy Mazumdar

Follow up: Dr. Drkaushal85 (2 minutes later)

1) I never smoke or drink
2) I think u have asked blood in coughing? I yes, No i dont have any such condition. And also coughing is no more there from today morning.
3) No never had any disease. But i always think there is a link with the wrist vascular complication.
Will be pleased to have your guidance further.

Answered by Dr. Drkaushal85 (3 minutes later)

Brief Answer:
Possibility of pulmonary embolism is very less.

Detailed Answer:
Thanks for your follow up question on Healthcare Magic.
I can understand your concern.
In my opinion, possibility of pulmonary embolism is very less.
If you don't mind I want to see your wrist picture.
May I?

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Drkaushal85 (4 minutes later)

Thank you so much for your prompt replies sir, please have a look at the wrist pictures

Answered by Dr. Drkaushal85 (5 minutes later)

Brief Answer:
Is it painful?

Detailed Answer:
Thanks for your follow up question on Healthcare Magic.
I can understand your concern.
I have gone through images you have attached.
No need to worry for this vein enlargement.
Is this site painful?
Is it hard to touch?

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Drkaushal85 (2 minutes later)

1) sometimes painful and sometimes tingling feeling as explained in the pdf chat with vascular surgeon as attached
2) No not hard to touch.
I seriously thank you for your immediate attention and prompt replies. It has helped me not to get worried. Will be please to hear further advice.

Answered by Dr. Drkaushal85 (11 minutes later)

Brief Answer:
Possibility of pulmonary embolism is very less.

Detailed Answer:
Thanks for your follow up question on Healthcare Magic.
I can understand your concern.
No need to worry for pulmonary embolism as its possibility is very very less.
But better to get done D dimer test to remove fear from mind.
Are you living in India?

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Drkaushal85 (5 minutes later)

Thank you so much sir.
Will do the test tomorrow first thing and i ll be sharing you the report.
Yes in XXXXXXX

Answered by Dr. Drkaushal85 (4 minutes later)

Brief Answer:
Please get it done in standard laboratory.

Detailed Answer:
Thanks for your follow up question on Healthcare Magic.
Please get it done in standard laboratory as this test is very very sensitive.
It's good that you are living in XXXXXXX
I can guide you where to go for test if you tell me your city of living.
In which city you are living?

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Drkaushal85 (1 minute later)

I actually travel for assignments. I was in Veraval near XXXXXXX for last 3 months. I will be in XXXXXXX for 2 more days till 29th eve. Will go back to Veraval then

Answered by Dr. Drkaushal85 (2 minutes later)

Brief Answer:
Are you Gujarati?

Detailed Answer:
Thanks for your follow up question on Healthcare Magic.
Are you belong to veraval?
Are you Gujarati?
I am also Gujarati. I am from XXXXXXX

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Drkaushal85 (2 minutes later)

No sir I am not a Gujarati. And yes I know you are from XXXXXXX I am currently doing assignment in veraval I belong to XXXXXXX XXXXXXX But started understanding Gujarati :)

Answered by Dr. Drkaushal85 (2 minutes later)

Brief Answer:
Are you traveling by plane?

Detailed Answer:
Thanks for your follow up question on Healthcare Magic.
I can understand your concern.
So you are having job which needs traveling.
Am I right?
Do you travel frequently by plane?
I am asking this because frequent air travel can cause pulmonary embolism.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Drkaushal85 (3 minutes later)

1) No the job doesnt need much travelling currently the job requires me to go places but that too in a limit
2)No i am not a frequent flyer. I have not flown more than 10 times as i have just started the job. But today only i fled from XXXXXXX to XXXXXXX (I am saying this because i had chest pain day before and breathlessness today). Still i did.
Will be pleased on further guidance.

Answered by Dr. Drkaushal85 (2 minutes later)

Brief Answer:
Do you have calf pain or tenderness?

Detailed Answer:
Thanks for your follow up question on Healthcare Magic.
I can understand your concern.
So you are having mixed history as far as flying is concerned.
Please let me
1. Do you have calf pain or tenderness?
I am asking this because DVT of calf veins often complicate as pulmonary embolism and DVT is common in frequent flyers.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Drkaushal85 (7 minutes later)

1) No i dont have as such persistent pain in the calf. But sometimes when i wake up it pains like its a vein pull or something like that (Hindi me we call it nas pe nas chadhna). Nothing beyond that because that goes away in minutes
2) I might have little tenderness as the doctor today itlsef said that nobody has red patches even after a safe process like ecg, but i got marks on chest on at V3, V4 and V5

Answered by Dr. Drkaushal85 (7 hours later)

Brief Answer:
Search for SRL laboratory or collection center.

Detailed Answer:
Thanks for your follow up question on Healthcare Magic.
I can understand your concern.
By your history and description, possibility of deep venous thrombosis (DVT) is very very less.
But better to get done D dimer test to remove fear from mind.
It is advisable to get it done by standard laboratory like SRL diagnostics.
So search SRL laboratory or collection center on Google near to you in XXXXXXX
They are having large number of collection centers in all parts of XXXXXXX
So get it done and let me know the results.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Drkaushal85 (10 hours later)

Hi Sir,
I did the d-dimer today, will get reports tomorrow evening. will share them.
Also i would appreciate any further advises.
Thanks

Answered by Dr. Drkaushal85 (2 minutes later)

Brief Answer:
No further advice.

Detailed Answer:
Thanks for your follow up question on Healthcare Magic.
This is good that you done the d dimer test.
From which lab you have done?
And no further advice unless you are having any symptoms.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Drkaushal85 (1 minute later)

Diagnostic centre, Hinduja Hospital

Answered by Dr. Drkaushal85 (7 minutes later)

Brief Answer:
It is a good institute.

Detailed Answer:
Thanks for your follow up question on Healthcare Magic.
Hinduja Hospital is a good institute.
Do you have any symptoms then let me know, I will guide you in further.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Drkaushal85 (2 hours later)

Sure, Sir, but how can i contact you in case of any emergency/symptoms after this chat? I ll be sharing all the reports with you.

Answered by Dr. Drkaushal85 (9 minutes later)

Brief Answer:
You can contact me directly on bit.ly/askdrkaushalbhavsar.

Detailed Answer:
Thanks for your follow up question on Healthcare Magic.
I can understand your concern.
I really appreciate your response.
It's always encouraging for doctors to hear positive feedback from patients. So thanks a lot for your kind words.
You can contact me directly on bit.ly/askdrkaushalbhavsar.
Click on this link and your question will be directed directly to me.
And I will be glad to receive your questions. I am always ready to help you.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar