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Got breathing difficulty and chest pain. No hypertension or diabetes. What could be the disease?

Jan 2013
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Internal Medicine Specialist
Practicing since : 2003
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Recently while on a vacation trip my wife got too tired, heavy breathing and a little chest pain on two occasions while climbing some 35 steps of a railway overbridge. An annual health checkup last year reported no issues-normal ecg, normal cholesterol. She has a heavy structure but no hypertension or diabetese. What tests should be performed to rule out serious conditions? She is 65 years old. We would like to avoid invasive tests as far as possible.
Posted Thu, 14 Feb 2013 in Hypertension and Heart Disease
Answered by Dr. Mayank Bhargava 1 hour later
Welcome to XXXXXXX forum.

With the available described symptomatology, there appear to be possibility of heart ailment.
Presence of chest pain along with difficulty in breathing suggests the diagnosis.
Although she has normal blood pressure, blood sugar and ECG, yet possibility of heart disease must be ruled out.
ECG is just a tracing of 1-2 minutes and it may be normal.

Breathlessness on exertion indicates inefficient blood pumping by heart.
When a person performs exercises or brisk walking, body needs extra oxygen supply and heart starts pumping blood at higher rate to fulfill body increased oxygen demand; thats why heart activity is increased during exercise.
If heart disease is present and heart is not able to pump blood, a person may have respiratory distress.

Other possibilities could be anemia (decreased hemoglobin with decreased oxygen supply), lung pathology.

You should consult with XXXXXXX medicine specialist and should go for thorough check up.
Although her last year blood reports were good but still she should go for repeat blood investigations like complete hemogram, lipid profile, chest x XXXXXXX electrocardiogram and stress test (highly significant as it also requires brisk walking and incompetency of heart may be demarcated).
She should also go for 2 D echo to detect ejection fraction (percentage of blood volume pumped by heart).

Let me know the reports of above prescribed investigations.

Hope that helps.
Let me know if I can address any more concerns.
Take care,
Dr. Mayank Bhargava
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