What causes shortness of breath, heart palpitations and constant weight loss?

Posted on Mon, 15 Feb 2016 in Digestion and Bowels
Question: hello my name is XXXXXXX and i am 23 years old

. I have been feeling bad for a year now but the last 4 months have been especially horrible. 8 months ago i had bad chest pain with shortness of breath and heart palpitations. I got a chest CT scan which was normal, and then my symptoms got a little better. 4 months later they came back but much worse . The heart palpitations were really bad and my shortness of breath also. I thought it might be a heart problem which my doc said was unlikely but we tested for it anyways. I had an echo/stress test done and wore a heart monitor for 2 weeks. Everything looked normal.
My doc said I was healthy but I knew and felt otherwise. Then other symptoms started to come on. I started to get pretty skinny although I was eating the same. I lost about 15-20 lbs in a couple month period. I started to get headaches everyday that weren't so bad but always present and felt like my head was in a vice grip or full of something. Everyday the headache would be there.
One day i woke up and my left knee was swollen/ filled with fluid. It was stiff. A few days later my right one did the same. It was painful to walk. I rested them, took NSAIDs and iced them but nothing helped.
It got so painful to walk that I had to go to the ER I literally was limping so badly. They did a number of tests and referd me to a rheumatologist saying it was probably a type of arthritis .
While I was waiting for appointment I had an MRI of my brain because the headaches wouldn't go away. Doc said it was completely normal and to follow up with the rheumy.
I went to the rheumatologist after a lot of blood work from my PCP. It showed elevated C-reactive protein and Sed rate. I took each test 3 times and by the 3rd the levels were normal again. My PCP prescribed me prednisone and that helped my knee swelling tremendously. It also helped my other symptoms and made me just feel normal for once.
The rhumetologist was not easy to diagnose anything. My CPR and see rate were now normal, antibodies and blood count were normal. Negative for rheumatoid factor. The only test that was positive was the HLA -b27 which would indicate spondylitis arthritis but she wasn't for sure. She said an arthritic condition shouldnt cause headaches constantly and weight loss . she was concerned about the weight loss and recommend a CT scan of my abdominal area. I did have frequent gas and diarea and just a slight burning sensation in my upper abdomen.

This scan showed some thickening/ inflammation of the lower part of my large intestine. My doctor was going out of town and said I can make an app with him when he returns to discuss what this means. It would be awhile to see him though so I am left here to think what that could mean and if this could be the root of my problems. Could something in my stomach be causing this? I have travel history to Peru and Argentina in the last 2 years so I was thinking it could be a type of parasite or something but my doctor didn't think so.

What do you think this inflammation / thickening of the lower part of my large intestine means? Could this be a reason for all my symptoms? Please let me know what you think. Thanks.
Answered by Dr. Tushar Kanti Biswas 19 hours later
Brief Answer:
Unexplained symptoms ? diagnosis

Detailed Answer:

Thank you for your query. I can understand your concerns.

It is quite possible that you had Enteropathic arthritis (acute pain and swelling of both knee joints,high CRP,elevated ESR and subsequent clinical response with normalization of CRP & ESR to steroids/prednisone).

HLA B27 can be positive in 30-70% of cases of Enteropathic arthritis , apart from Ankylosing spondylitis (positive in >90% of cases).

Thickening/inflammation of the lower part of large intestine on CT scan of abdomen is a non-specific finding. You need to undergo colonoscopy to take biopsy from the site of lesion and identify the etiology.

Crohn’s disease(CD) , a form of IBD(Inflammatory bowel disease) can cause arthritis as well as chronic bowel inflammation causing fibrostenotic pattern of ileocecal region with localized wall thickening.

Both CT and MRI enterography (CTE or MRE), using oral and IV contrast can also be more informative.

Your headache and episodes of chest pain is unexplained for , as nothing organic could be made out.

One infective cause which can cause myriad of symptoms is Lyme's disease as it is prevalent in that side of hemisphere.

Let me know if there's any further queries in this aspect.


Dr. T.K. Biswas M.D. XXXXXXX

Above answer was peer-reviewed by : Dr. Arnab Banerjee
Answered by
Dr. Tushar Kanti Biswas

Internal Medicine Specialist

Practicing since :1975

Answered : 1909 Questions


The User accepted the expert's answer

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