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Suggest Treatment For Severe Chest Pain And Shortness Of Breath
Question: Hi, I had a blood test done 4-5 months ago which went wrong (a suspected blood clot was created) and some complications were resulted. Please refer to the pdf attached named 'Vein issue' for details. That is the chat with the surgeon. But 2 weeks back i had severe chest pain followed by shortness of breath. Please refer to the pdf named 'pulmonologist' for details. I dont have chest pain anymore and I have also consulted pulmonologist both at Hinduja XXXXXXX and on this portal and i did some tests including D-Dimer, CT Scan, X ray, ECG. everything was normal according to them. But i still have 'breathlessness' and this the point of raising this query. Please advise me if this can be due to some cardio issue. I am really scared as breathlessness is irritating me a lot since 2 weeks.
Brief Answer:
please provide more details
Detailed Answer:
Dear Sir
I have gone through your queries asked in the past and replies given by the worthy doctors. I have following submission in this regard.
1. Kindly upload the report of CT scan which was done for evaluation of breathlessness. Please also upload all ECGs which were done in last 6 months.
2. If you have undergone Echocardiography? If yes, please upload the report.
3. At what time do you feel breathless? If it is related with any kind of physical exercise? If it occurs after same magnitude of exercise every time? How long it lasts? Are there any accompanying symptoms? How is it relieved? Does your breath sounds whistle at time of breathlessness?
Waiting for your reply and uploading.
Sincerely
Sukhvinder
please provide more details
Detailed Answer:
Dear Sir
I have gone through your queries asked in the past and replies given by the worthy doctors. I have following submission in this regard.
1. Kindly upload the report of CT scan which was done for evaluation of breathlessness. Please also upload all ECGs which were done in last 6 months.
2. If you have undergone Echocardiography? If yes, please upload the report.
3. At what time do you feel breathless? If it is related with any kind of physical exercise? If it occurs after same magnitude of exercise every time? How long it lasts? Are there any accompanying symptoms? How is it relieved? Does your breath sounds whistle at time of breathlessness?
Waiting for your reply and uploading.
Sincerely
Sukhvinder
Above answer was peer-reviewed by :
Dr. Yogesh D
Thank you so much for the concern doctor. Here are the answers to the details asked by you:
1) I am uploading the images of the ECG done 2 weeks ago (file names ecg1 & ecg2)
I have still not got the full report of CT Scan but i am uploading the provisional report with file names ct1 and ct2
2) I have not undergone echo. Please let me know if this should be done.
3)Mostly the breathlessness comes with the ending hours of office i.e. from 4-4:30 and its last till late evening 9-9:30. In the night when I sleep, i feel fine enough. I dont know i am still figuring out the pattern of this breathlessness, but till now if i stand for some time it comes but this also happens around 4 in the evening when i am just sitting in the office. It lasts until I sleep after which i dont feel this (maybe it still persists). Yes, whenever breathlessness is there I feel the vein in hand(vein as discussed with issue) swells along its path down towards the palm and I feel a pain in the palm(along the path of the vein), a concentrated pinching pain. It is relieved on its own or when i sleep. No it does not sound like a whistle.
Please help on this i am worried a lot and i need to travel to USA for business this 23rd. I dont know if i ll be able to with this condition.
1) I am uploading the images of the ECG done 2 weeks ago (file names ecg1 & ecg2)
I have still not got the full report of CT Scan but i am uploading the provisional report with file names ct1 and ct2
2) I have not undergone echo. Please let me know if this should be done.
3)Mostly the breathlessness comes with the ending hours of office i.e. from 4-4:30 and its last till late evening 9-9:30. In the night when I sleep, i feel fine enough. I dont know i am still figuring out the pattern of this breathlessness, but till now if i stand for some time it comes but this also happens around 4 in the evening when i am just sitting in the office. It lasts until I sleep after which i dont feel this (maybe it still persists). Yes, whenever breathlessness is there I feel the vein in hand(vein as discussed with issue) swells along its path down towards the palm and I feel a pain in the palm(along the path of the vein), a concentrated pinching pain. It is relieved on its own or when i sleep. No it does not sound like a whistle.
Please help on this i am worried a lot and i need to travel to USA for business this 23rd. I dont know if i ll be able to with this condition.
Brief Answer:
please see details.
Detailed Answer:
Dear Sir
1. The temporal pattern of breathlessness is usually against an organic cause except for certain asthma like disorders. The report of CT scan sys there is no significant abnormality. ECG has biphasic T in V1 that may be a normal variant.
2. For any person who wants to rule out a cardiac issue behind breathlessness first step is usually a cardiac ultrasound (Echocardiography). If echocardiography turns out to be normal, the chances of a cardiac cause causing breathlessness at rest is very low. A stress test may be done after a normal ECHO do further ascertain exact exercise capacity, organic basis of breathlessness and contribution of any coronary artery disease.
3. I would request you to kindly consult a cardiologist in person (during evening hours) before undergoing all these test. As a normal clinical examination during symptoms may avert unnecessary testing.
Sincerely
Sukhvinder
please see details.
Detailed Answer:
Dear Sir
1. The temporal pattern of breathlessness is usually against an organic cause except for certain asthma like disorders. The report of CT scan sys there is no significant abnormality. ECG has biphasic T in V1 that may be a normal variant.
2. For any person who wants to rule out a cardiac issue behind breathlessness first step is usually a cardiac ultrasound (Echocardiography). If echocardiography turns out to be normal, the chances of a cardiac cause causing breathlessness at rest is very low. A stress test may be done after a normal ECHO do further ascertain exact exercise capacity, organic basis of breathlessness and contribution of any coronary artery disease.
3. I would request you to kindly consult a cardiologist in person (during evening hours) before undergoing all these test. As a normal clinical examination during symptoms may avert unnecessary testing.
Sincerely
Sukhvinder
Above answer was peer-reviewed by :
Dr. Prasad
sir attached is the 2d echo report please give your valued opinion
Brief Answer:
ECHO report is within normal limits.
Detailed Answer:
Dear XXXXXXX
The ECHO report is normal. There can not be breathlessness due to cardiac cause at rest with this report which does not increases on exercise / exertion.
As I told you earlier, theoretical next step in such cases is an exercise stress test like TMT (exercise ECG). It will help in knowing many things as detailed above. You must get a prescription of same from a physician or a cardiologist. Do not undergo stress test without a prescription.
Sincerely
Sukhvinder
ECHO report is within normal limits.
Detailed Answer:
Dear XXXXXXX
The ECHO report is normal. There can not be breathlessness due to cardiac cause at rest with this report which does not increases on exercise / exertion.
As I told you earlier, theoretical next step in such cases is an exercise stress test like TMT (exercise ECG). It will help in knowing many things as detailed above. You must get a prescription of same from a physician or a cardiologist. Do not undergo stress test without a prescription.
Sincerely
Sukhvinder
Above answer was peer-reviewed by :
Dr. Yogesh D
Thanks for the reply sir, i ll take care of this even 2d echo wasn't without prescription. but I have one doubt. I would appreciate if you can solve that. MV in echo says something for which the lab guy has put suspicion in my mind. I would request you to please clarify this by a relook at report
Brief Answer:
Not significant
Detailed Answer:
Dear XXXXXXX
I have seen that. The Mitral valve is said to be sclerosed without further details. Sclerosis simply means ageing of tissue. It is akin to graying of hair. No other structural abnormality is present along with sclerosis. Since there is no significant obstruction or leakage associated with it, it does not carry any significance at present.
Be assured.
Sincerely
Sukhvinder
Not significant
Detailed Answer:
Dear XXXXXXX
I have seen that. The Mitral valve is said to be sclerosed without further details. Sclerosis simply means ageing of tissue. It is akin to graying of hair. No other structural abnormality is present along with sclerosis. Since there is no significant obstruction or leakage associated with it, it does not carry any significance at present.
Be assured.
Sincerely
Sukhvinder
Above answer was peer-reviewed by :
Dr. Yogesh D
Thank you so much Doctor, but the breathlessness, coughing and a chest pain (which happened only once) started recently after my vascular problem. So is there a chance that this can be the cause of it? If yes, should we not do anything about it? The point is that I have never in 23 years experiences such difficulties. Suddenly they come, does it signify something? Should I be worried and seeing anyone physically? I am so tensed since the day Echo has come. Please help me on this. I will be highly thankful.
Brief Answer:
please see details.
Detailed Answer:
Dear Sir
1. Whatever i could get from the details of your discussion with the surgeon, I could get that it is a local problem. A Normal CT angiogram of pulmonary arteries will essentially rule out any possibility of your breathlessness being related to the venous problem. But I still feel, instead of getting so many investigations done, it is better to see a good physician. Theoretically possibility of a large clot going from such a peripheral vein in arm is very low but not out.
2. An exercise stress will tell us that if you really have breathlessness related to exertion or not. A normal exercise capacity will eventually put a full stop on all physical possibilities. We may consider anxiety as cause at that juncture.
3. Your ECHO report was good and you must not be tensed about it.
Sincerely
Sukhvinder
please see details.
Detailed Answer:
Dear Sir
1. Whatever i could get from the details of your discussion with the surgeon, I could get that it is a local problem. A Normal CT angiogram of pulmonary arteries will essentially rule out any possibility of your breathlessness being related to the venous problem. But I still feel, instead of getting so many investigations done, it is better to see a good physician. Theoretically possibility of a large clot going from such a peripheral vein in arm is very low but not out.
2. An exercise stress will tell us that if you really have breathlessness related to exertion or not. A normal exercise capacity will eventually put a full stop on all physical possibilities. We may consider anxiety as cause at that juncture.
3. Your ECHO report was good and you must not be tensed about it.
Sincerely
Sukhvinder
Note: For further queries related to coronary artery disease and prevention, click here.
Above answer was peer-reviewed by :
Dr. Prasad
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