Question: Sympotoms: Hi, My father who is about 58 years old, have following symptoms: He feels fullness in stomach, pressure and squeezing and discomfort in chest, difficulty breathing and short breath, and anxiety. This happens any time (even while sitting in office or lying on bed), sometimes it is severe and lasts upto 30 minutes and sometimes it is for short time and mild. Most of the times, he sweats during this period (even in winters). Gets relief after having some burps which comes out on walking and situation worsen when sitting and lying. These burps, during severe symptoms cycle, have a strange sound like air is coming out of some loose and soft tissues. This usually occurs when he eats something heavy or difficult to digest like milk products, spicy etc. During last ECG, the lab technician asked to hold the breath and he observed some vibration. However the ECG result was normal. My question is if this is a heart related problem or gastric related problem? What tests should he undergo for the diagnosis? Last time we noticed that BP was very low after the attack: 90/60 and he felt very very weak. Always goes to bed after 1 hour after dinner and his bed is elevated as advised. During nights, he feel too anxious and often no good sleep. Often wakes up in night and difficulty in getting sleep again.

What you have already tried: Pantoprazole 40mg for 8 weeks course taken in april-may and again started this week after getting severe symptoms again which lasted around 45 minutes, after consulting GP. Before taking Pantoprazole course of 8 weeks, in Apr May 2014, almost daily chest felt like squeezed or with pressure up to about midday since waking in the morning and the course provided relief that time. ECG shows no abnormility. Endoscopy has not been done yet. Cholestrol, sugar, are normal. HDL(28mg/dl) is low, Sodium(128 mmol/l), Potassium(2.5mmol/l) is low. During the symptom attack, BP becomes very low. For excessive stomach gas and flatulence used Zantac for 12 years whenever gas occurred. Now as described above the chest problem also started along with.

Medical History: Having prostate (grade II prostatomegaly[43.3 gm] with about 120 ml PVR). Found two small 6mm and 8mm simple lever cysts in left lobe of lever. Chest xray is normal. No other abnormalities found in ultrasound. Has inguinal hernia since last 10 years and uses hernia belt and no corrective surgery is done yet.


Known Allergies: Hard antibiotics and medications and dry fruits starts loose motion. In deep anxiety and stress bowel movement occurs.

Thank you sir for your advice,
please suggest what specific tests and procedures he should undergo or which specialist be consulted (gastro, cardiac or both)? And to find the reason behind sodium and potassium lower values, what should be our next course of action? As you have doubt of a bigger symptom then please tell us what what blood tests, hormone tests, and therapy he must undergo?
Thank you.