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Dr. Andrew Rynne

Family Physician

Exp 50 years

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Can heart issues cause cough with breathlessness and coughing up phlegm?

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Dr. Jnikolla

Pulmonologist

Practicing since :2003

Answered : 1348 Questions

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Posted on Thu, 26 Apr 2018 in Lung and Chest disorders
Question: My inquiry is actually in regards to my fiancee. His name is XXXXXXX He is 41 years old, 5' 5" and 205 lbs. He has been going through a series of medical issues that are beginning to seriously concern me. To start he has had a persistent cough for several months. I had been trying to get him to the to see a do without success. Finally, about 3 weeks ago this cough turned into something fairly severe and it had physically took him down. The energy it took him to just get out of bed to go to the bathroom exhausted him! He missed 4 days of work. Which is an entire week as he works 10 hours a day for 4 days a week. On the 5th day, I got him to go to an urgent care clinic. The doctor seemed fairly concerned. He ordered a cheat xray. When the report from the radiologist came back, the doctor came in and said, "Well, you're gonna live, but the Cray did not look well"! He said he wasn't contagious and he did not have Bronchitis or Pneumonia, but there was an infection in all 4 chambers of his lungs. He prescribed him a Z-pack and 4 days of 30mg of prednisone. He stressed that it was very important that he follow up with his primary care physician. In addition to whatever was going on with his lungs, the doctor expressed concern for his blood pressure and suggested he have a full panel of blood work done when he sees his general practitioner. We left and picked up his prescriptions at Walgreens. While we were waiting for the pharmacist to fill his scripts, I had XXXXXXX check his blood pressure. It was 142/98 and his heart rate was 114! We have a BP machine at home and periodically check our BP. His heart rate is always over 100 and BP is typically slightly elevated, but not high. More like what a doc would consider borderline.

That's a little history. Now this is my concern. He still has this cough. Only now there are some other symptoms that concern me even more! He seems to be struggling even more to get air! His breathing has become rapid with shorter breaths. Especially after doing anything physical. He is coughing up much more phlegm. That may be because all of what was in his lungs is working it's way out. I don't really know. When he lays flat he seems like he literally stops breathing for a few seconds and all of the sudden he will sit straight up an gasp. Then he nearly starts to hyperventilate! I had Asthma as a child and would go through the same sort of symptoms. So I understand what he is dealing with to an extent. What I don't understand is the fact that he hasn't bothered to follow up with the doc or even consider going back for the lung infection since obviously the lungs haven't cleared up. I'm actually starting to think that he has a heart condition and it's not his lungs that are causing his struggle to breathe! He was adopted at birth and doesn't know a single but of his biological families health history.

My purpose of submitting my inquiry today is to hopefully get some professional input that may convince him that he needs to return to the doctor and be reevaluated and hopefully start getting the proper treatment for whatever this condition may be.I thank you in advance.
doctor
Answered by Dr. Jnikolla 40 minutes later
Brief Answer:
please do the following tests at first

Detailed Answer:
Hello and thank you for asking,

I can understand your concern and I am sorry for his situation.

As you explain the history this is a condition that needs medical specialist follow up, I mean a pulmonologist and a cardiologist too.

It is not so clear to me the report of chest X-Ray. If it is bilateral pneumonia this is a serious situation and if he is experiencing breathlessness continuously this is not a good sign.

The blood pressure and heart rate might be elevated now due to the lungs suffering. However, an ECG and a cardiac ultrasound should be done to exclude heart problems too.

If he were my patient I would order the general check-up and also CRP, PPD test, Arterial blood gases and probably a chest CT and then decide about the right treatment.

If you do the above please attach the results here for my review. Please discuss with his doctor for the above.

Regards and feel free to ask me again

Dr.Jolanda


Above answer was peer-reviewed by : Dr. Arnab Banerjee
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Follow up: Dr. Jnikolla 1 hour later
I am really pleased with the fact you specifically answered my inquiry! Being a pulmonologist as well as a cardiologist, maybe he'll actually take your advice. I don't understand why it is so difficult for him to seek medical attention. His mother is a NICU RN at Swedish Hospital and his father is the head of radiology at the University of XXXXXXX His mother knows a little bit about what his medical issues have been lately, but I don't think his father knows at all. I see the Deep look of concern on his mother's face when we go to visit her. She has given him medicine and advise as to what he can do to maybe help himself get well. Him and I have been together for three and a half years and this recent doctor visit is only the second time he has gone to the doctor since we met! Anyway, Thank you again! I will definitely keep you posted and let you know what the outcome is. Have a wonderful day!
doctor
Answered by Dr. Jnikolla 10 hours later
Brief Answer:
continue discussion

Detailed Answer:
Hello again

Probably he is afraid of however you are welcome

Regards

Dr.Jolanda
Above answer was peer-reviewed by : Dr. Nagamani Ng
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