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Hi! Slightly Sob Last Fall/winter But It Went Away. Came
Question: Hi! Slightly sob last fall/winter but it went away. Came back this fall. Sob when talking to my patients..feel like I have to gulp air or yawn every few minutes. I’m 48, have sinus tachycardia which I’ve been taking propanol for 4+ years now. Went to emergency room - clear Angio chest CT, normal chest X-ray, normal bloodwork and BNP/troponin. Ekg stable from 4 years ago. Full cardiac work up in 2016 = normal. My upper airways feel “tight” and my sternum hurts to press on the sides. Occasional stabbing chest pains. Could it be long term propanol use? Adult asthma (inhaler hasn’t helped)? I also suffer from anxiety so what started out as a mole hill now feels like a mountain. I sleep well at night with no breathing issues but when I wake it starts all over again as soon as I “think” about being breathless...
Brief Answer:
Anxiety can be a cause of your symptoms. Propranolol is not safe in asthma
Detailed Answer:
Hello and welcome to Ask a Doctor service,
Propranolol is not a good beta blocker in patients with asthma as it may cause bronchospasms and shortness of breath. Atenolol or metoprolol may be safer to use in a patient with asthma.
I also believe that your symptoms can be related to anxiety. As all the tests and examinations come out normal this is a very likely diagnosis.
I would recommend you to check your TSH levels to make sure your thyroid function is normal as thyroid problems can cause problems with anxiety.
If the thyroid function is normal, I would recommend you to take an SSRI drug daily.
So, to conclude:
- Atenolol and metoprolol are safer choices in patients with reactive airways and may be considered to be used instead of propranolol
- Checking TSH would be helpful to rule out thyroid function disorders.
- Anxiety is very likely the cause of your symptoms and an SSRI drug (sertraline, citalopram or paroxetine, for instance) can be taken daily to treat it.
I hope I have answered your query. Let me know if I can assist you further.
Regards,
Dr. Antoneta Zotaj,
General & Family Physician
Anxiety can be a cause of your symptoms. Propranolol is not safe in asthma
Detailed Answer:
Hello and welcome to Ask a Doctor service,
Propranolol is not a good beta blocker in patients with asthma as it may cause bronchospasms and shortness of breath. Atenolol or metoprolol may be safer to use in a patient with asthma.
I also believe that your symptoms can be related to anxiety. As all the tests and examinations come out normal this is a very likely diagnosis.
I would recommend you to check your TSH levels to make sure your thyroid function is normal as thyroid problems can cause problems with anxiety.
If the thyroid function is normal, I would recommend you to take an SSRI drug daily.
So, to conclude:
- Atenolol and metoprolol are safer choices in patients with reactive airways and may be considered to be used instead of propranolol
- Checking TSH would be helpful to rule out thyroid function disorders.
- Anxiety is very likely the cause of your symptoms and an SSRI drug (sertraline, citalopram or paroxetine, for instance) can be taken daily to treat it.
I hope I have answered your query. Let me know if I can assist you further.
Regards,
Dr. Antoneta Zotaj,
General & Family Physician
Above answer was peer-reviewed by :
Dr. Nagamani Ng
thank you for your answer. i do think i may have adult onset asthma and am seeing a pulmonologist in a few days so hopefully testing can be done. I definitely have anxiety which is not helping - but am not having bad chest pain after eating a large meal..its VERY uncomfortable! im wondering if a hiatal hernia and some GERD could be coming into play slso. i spend several hours with relux and burping after dinner!
Brief Answer:
GERD can cause shortness of breath only if aspiration of acid content happens (may imitate asthma)
Detailed Answer:
Hello and welcome back,
It is good you are having a check to be evaluated for asthma. As for GERD and hiatal hernia, I would not expect them to cause shortness of breath unless there is some aspiration of the acid reflux during the night. This would also cause symptoms similar to asthma.
The way to know about acid reflux affecting you is to have a trial of omeprazole for 2-3 weeks and see if it helps and also be cautious to avoid large meals (eat frequent small amounts of food during the day) and also not eat the last 3-4 hours before bedtime. Avoiding smoking, alcohol, and caffeine would be helpful as well. Greasy food and spicy food may make reflux worse.
If you try the omeprazole 40 mg 30 minutes before breakfast and the diet measures for 2-3 weeks and you see no improvement it is highly likely your symptoms are not due to acid reflux.
An endoscopic examination may assist the diagnosis as well.
You will need to consider the checks for anxiety and also see the need for medications for anxiety if medications for GERD do not offer good relief.
GERD can cause shortness of breath only if aspiration of acid content happens (may imitate asthma)
Detailed Answer:
Hello and welcome back,
It is good you are having a check to be evaluated for asthma. As for GERD and hiatal hernia, I would not expect them to cause shortness of breath unless there is some aspiration of the acid reflux during the night. This would also cause symptoms similar to asthma.
The way to know about acid reflux affecting you is to have a trial of omeprazole for 2-3 weeks and see if it helps and also be cautious to avoid large meals (eat frequent small amounts of food during the day) and also not eat the last 3-4 hours before bedtime. Avoiding smoking, alcohol, and caffeine would be helpful as well. Greasy food and spicy food may make reflux worse.
If you try the omeprazole 40 mg 30 minutes before breakfast and the diet measures for 2-3 weeks and you see no improvement it is highly likely your symptoms are not due to acid reflux.
An endoscopic examination may assist the diagnosis as well.
You will need to consider the checks for anxiety and also see the need for medications for anxiety if medications for GERD do not offer good relief.
Above answer was peer-reviewed by :
Dr. Prasad
that was supposed to say i AM having bad chest pain after my evening meal.
Brief Answer:
GERD and hiatal hernia may cause similar symptoms.
Detailed Answer:
Hello and welcome back,
Chest pain after a large meal can be due to acid reflux. As mentioned above, there are two options. One is to try omeprazole 40 mg 30 minutes before breakfast for 2-3 weeks together with the measures to reduce acidity (frequent small meals, avoiding meals 3-4 hours before bedtime, avoiding caffeine, alcohol and smoking, avoiding greasy, spicy food, etc).
The other option is to have the upper endoscopy done to check for evidence of GERD and hiatal hernia.
I hope this answers your query and is helpful to you.
Let me know if you have more questions.
Regards,
Dr. Antoneta Zotaj
GERD and hiatal hernia may cause similar symptoms.
Detailed Answer:
Hello and welcome back,
Chest pain after a large meal can be due to acid reflux. As mentioned above, there are two options. One is to try omeprazole 40 mg 30 minutes before breakfast for 2-3 weeks together with the measures to reduce acidity (frequent small meals, avoiding meals 3-4 hours before bedtime, avoiding caffeine, alcohol and smoking, avoiding greasy, spicy food, etc).
The other option is to have the upper endoscopy done to check for evidence of GERD and hiatal hernia.
I hope this answers your query and is helpful to you.
Let me know if you have more questions.
Regards,
Dr. Antoneta Zotaj
Note: For further queries related to coronary artery disease and prevention, click here.
Above answer was peer-reviewed by :
Dr. Vaishalee Punj
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