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Dr. Andrew Rynne
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Dr. Andrew Rynne

Family Physician

Exp 50 years

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Suggest treatment for shortness of breath, heart palpitations and wheezing

Answered by
Dr.
Dr. Lilit Baghdasaryan

Cardiologist

Practicing since :2007

Answered : 1536 Questions

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Posted on Tue, 27 Jan 2015 in Lung and Chest disorders
Question: I have been getting very short of breath with fast heartbeat and wheezing after walking for just a few minutes (not always, but at least daily). This is a change I'm concerned about. I do have asthma, but also risk factors for heart disease. and some edema/bloating and intermittent chest pain;/tightness. Thank you.
doctor
Answered by Dr. Lilit Baghdasaryan 36 minutes later
Brief Answer:
Need more details

Detailed Answer:
Dear Mrs,

To answer your query I need more information

1. Could you please provide your cholesterol data
2. have you done ECG and echocardiography, stress test previously
3. what additional risk factors do you have (you have mentioned about risk factors), do you have heredity for ischemic heart disease
4. does your chest pain connected with physical activity, is there any provocative factor for your chest pan. And I would like to know whether it increases with movements, breathing
5. how long have you been taking atorvastatin, what is the dose and cholesterol levels after

Regards,
Above answer was peer-reviewed by : Dr. Shanthi.E
doctor
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Follow up: Dr. Lilit Baghdasaryan 13 hours later
Thank you, doctor.

To answer your questions:

1. I don't have my current cholesterol data. All I know is that my cholesterol and triglyceride levels were quite high a few years ago, but last I heard they had gone down while taking atorvastin.

2. I did have ECG and echocardiogram at least one year ago. Results were normal.

3. Risk factors include former smoker (quit 15 years ago, but smoked heavily for about 30 years); my age (64); heredity (father, brother, 2 grandparents, several aunts and uncles had/have heart disease); high stress level for years (plus depression).

4. Chest pain does not seem to be connected with physical activity or breathing - but shortness of breath and fast heartbeat are definitely connected to physical activity (have had to stop after walking only a few minutes).

5. I've been taking atorvastatin for about 4 years (20 mg/day increased from 10/mg) - don't know results of last blood tests and am inbetween primary care doctors.

Hope this helps. XXXX

doctor
Answered by Dr. Lilit Baghdasaryan 7 hours later
Brief Answer:
Need to repeat some cardiology examinations

Detailed Answer:
Dear Mrs XXXX,

Thank you for detailed information.

Sometimes it is a real challenge for doctors to diagnose heart failure in early stages especially in patients with lung problems and anxiety/depression.
You don't have underlying heart disease; theoretically you shouldn't have heart failure. But you have asthma, which, if severe, can cause right heart failure, and have strong heredity. So, heart failure as a cause of shortness of breath should be excluded.
I would advise you to repeat echocardiography, to check whether there is worsening or not, undergo stress test to exclude coronary artery disease and serum BNP for excluding heart failure.

Hope I could help you

Please, let me know if you have further questions

Wish you good health

Regards,

Above answer was peer-reviewed by : Dr. Bhagyalaxmi Nalaparaju
doctor
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Follow up: Dr. Lilit Baghdasaryan 1 hour later
Thank you, Dr. Baghdasaryan.

I think you meant to write that heart failure as a cause of shortness of breath should NOT be excluded (you left out "not"), based on the rest of your answer.

Maybe it goes without saying, but when I have shortness of breath and feeling of heart pounding, I also feel very weak, and just have to stop walking before going on.

I really don't think that anxiety or depression plays a role in those symptoms when I'm physically active, because I'm being treated for those conditions and don't feel anxious at the time.

All this seems to reinforce what you say about being re-tested etc.

One more question:

Several years ago, I had a couple of abdominal MRI's to investigate possible lymphoma. Besides findings of lesions on spleen and elsewhere, there was an incidental finding: the report stated "There is calcification in the coronary arteries." Does that seem significant to you in terms of possible heart disease?

Thanks again, XXXXXXX
doctor
Answered by Dr. Lilit Baghdasaryan 5 hours later
Brief Answer:
Don't worry, you need to do just some examinations

Detailed Answer:
Dear XXXXXXX

You understand correctly, heart failure should be ruled out as a possible cause of breathlessness. BNP and NT-proBNP are very useful tests to rule out heart failure.

If there were calcification in coronary arteries it may indicate coronary artery disease. Stress test will help to confirm or rule out the diagnosis. For my female patients I prefer nuclear stress test. In your case your doctor will discuss with you and decide the appropriate test

Wish you a good health

Regards,

Above answer was peer-reviewed by : Dr. Vaishalee Punj
doctor
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Follow up: Dr. Lilit Baghdasaryan 2 days later
This is related to previous questions I asked here: I had severe wheezing and shortness of breath while walking in the cold several hours ago. A couple of hours later I began having pretty bad tightness in my chest which has lasted for 2 or 3 hours (at rest). It's still going on but less intense. Should I be especially worried right now, or just go to sleep? I do have asthma (not usually relieved by albuterol) but also some symptoms of and risk factors for heart disease. Mainly my shortness of breath has been much worse in recent months and sometimes have peripheral edema and have strong family history of ischemic heart disease. Am taking Atorvastatin for high cholesterol, not sure of current cholesterol levels.

Just want to add, since this question is so much like earlier one: This episode of breathlessness and wheezing (and pounding heart) in the cold on a short walk earlier today was the worst I've ever had - and this episode of chest tightness has lasted longer than any other I remember. I also have trouble with stairs, feel weak and try to pull myself up by the banister.
doctor
Answered by Dr. Lilit Baghdasaryan 51 minutes later
Brief Answer:
Need to undergo ECG and cardiac enzymes

Detailed Answer:
Dear XXXXXXX

The breathlessness and wheezing more likely are related to asthma.
For chest tightness if it lasted longer than usually, I would advise you to perform ECG and cardiac enzymes today

Regards,


Above answer was peer-reviewed by : Dr. Bhagyalaxmi Nalaparaju
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