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Suggest Treatment For Severe Anxiety, Chest Pain And Breathlessness

Posted on Mon, 15 Feb 2016

Question: Hello doctor. I recently had a chest ct because of excessive mucus. I had this problem since i was 25 and time to time i had chest pain, excessive mucus and problem with breath, and i did a chest x ray on that time but it did not come up with anything and the doctor told me that i had probably anxiety, which i did develop eventually because i was in the same condition for 3-4 years. After 4 years the chest pain and breathing problem dissappear but mucus still there. 2 weeks ago i noticed blood in the saliva in the morning, not much but enough to worry me, it was pink. I had it for a week every morning. After i was spitting it out my saliva was ok for the rest of the day, than it stopped for 4-5 days to come back this morning with bigger volume and red in colour, also today i was cleaning the throat the pink bloody saliva came up, this time in afternoon for the first time. I have a visit with the respiratory specialist in 17 days but it feels so far to me and this condition is freaking me out. Ct scan came with a report saying " Cavity in the right pulmonary apex possibly a varicose bronchiectatic segment. There is ne significant mass effect. I doubt that this represent a cavitary metastatic focus"

Answered by Dr. Drkaushal85 (35 minutes later)

Brief Answer:
No need to worry for metastatic cavitory lesion.

Detailed Answer:
Thanks for your question on Health Care Magic.
I can understand your concern.
First of all no need to worry for metastatic cavitory lesion.
CT scan is highly specific for diagnosis of metastatic lesion. It is best to differentiate between benign and malignant lesion.
And lung metastases are uncommon at your age of 34 years.
So no need to worry for malignancy.
You are mostly having bronchiectesis. Your symptoms are also in favour of bronchiectesis.
It is dilatation of airways due to previous lung infection. In dilated airways, secretions tend to accumulate and cause infection. So patient gets recurrent episodes of cough, expectoration, breathlessness, hemoptysis (blood in sputum) etc.
So no need to worry for malignant foci. Your symptoms are due to bronchiectesis only.
You will need mucolytic, expectorant, inhaled bronchodilators and inhaled corticosteroid (ICS).
Don't worry, you will be alright. Forget about metastatic cavitory lesion.
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. Vaishalee Punj

Follow up: Dr. Drkaushal85 (24 minutes later)

Thank you Doctor, I forgot to mention that I am an ex smoker. I smoked for 8 years but now I am smoke free. I have attached ct scan report, if you could have a look please, i have and ct scan photos if you would like to have a look. Thank you

Answered by Dr. Drkaushal85 (6 hours later)

Brief Answer:
No need to worry for metastatic cavitory lesion.

Detailed Answer:
Thanks for your follow up question on Health Care Magic.
I can understand your concern.
I have gone through the images you have attached.
No need to worry for metastatic cavitory lesion.
Please let me know
1. Have you ever undergone PFT (Pulmonary Function Test)?
2. Did you have any lung infection 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 (1 hour later)

I have done PFT which the results were better than my doctor expcted (around 122%) and I had no known lung infection ( unless the symptoms i had when i was 25 were from lung infection and the doctor at that time did not find it). As for the blood in the mouth today I found where it was coming from, it was coming from my gums. :). Thank you Doctor for quick response. I really appreciate that

Answered by Dr. Drkaushal85 (5 hours later)

Brief Answer:
Do take adult Pulmonary vaccines.

Detailed Answer:
Thanks for your follow up question on Health Care Magic.
I can understand your concern.
Yes, gum bleeding can also gives false belief of blood coming from lungs.
So no need to worry much, consult dentist and get done treatment for bleeding gums.
Since you are having bronchiectesis, better to take adult Pulmonary vaccines .
Bronchiectesis is known to have recurrent lung infection. So to prevent this, vaccines should be taken.
Please let me know if you have taken or heard of these Pulmonary vaccines.
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 (1 hour later)

Thank you Doctor. I have not taken and I never heard of these vaccines, but I will let the specialist knows when I see him. Any other advice until i see the specialist? Thank you

Answered by Dr. Drkaushal85 (5 minutes later)

Brief Answer:
Do you have breathing difficulty at present?

Detailed Answer:
Thanks for your follow up question on Health Care Magic.
You should definitely ask for adult Pulmonary vaccination to prevent recurrent lung infection.
Also let me know
1. Do you have breathlessness on exertion?
2. Do you have wheezing or chest tightness at present?
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 (21 minutes later)

The only symptom i have is exces mucus and blocked nose and sometime i feel like i cant get deep breath ( but i feel like this is coming from my stomach as i have gastritis and I am taking nexium at the moment)i have no sinus as i have done x ray 6 months ago. I run more than my wife who is 6 years younger than me i got plenty of stamina and i lift weights with no problem. Thank you Doctor

Answered by Dr. Drkaushal85 (21 minutes later)

Brief Answer:
No need to worry much for your CT finding.

Detailed Answer:
Thanks for your follow up question on Health Care Magic.
I can understand your concern.
In my opinion, you should not worry much for your CT finding. It is bronchiectesis only.
No need to fear for metastatic cavitory lesion.
Consult pulmonologist and discuss all our conversations.
Do let me know your progess.
Hope I have solved your queries.
If you are not having further queries then please close the conversation and rate my answer.
You can ask me directly on bit.ly/askdrkaushalbhavsar.
Wish you good health. Thanks.

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

Follow up: Dr. Drkaushal85 (15 minutes later)

Thank you Doctor. Your help is much appreciated.

Answered by Dr. Drkaushal85 (8 minutes later)

Brief Answer:
Please close the conversation and rate my answer.

Detailed Answer:
Thanks for your follow up question on Health Care Magic.
It's always encouraging for doctors to hear positive feedback from patients. I am truly obliged. Thanks again.
Do let me know your progess.
Hope I have solved your queries. If you are not having further queries, then please close the conversation and rate my answer.
You can ask me directly on bit.ly/askdrkaushalbhavsar.
Wish you good health. Thanks.

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