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Dr. Andrew Rynne
Dr. Andrew Rynne

Family Physician

Exp 50 years

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What causes shortness of breath in a COPD and asthma patient?

Answered by
Dr. Ilir Sharka


Practicing since :2001

Answered : 7011 Questions

Posted on Thu, 22 Sep 2016 in Hypertension and Heart Disease
Question: I am a heart patient for about 30 years after my MI in 1884. For the past 2 years the dailyswelling in my power legs is increasing and I started having a problem just about every night between 2 - 4 AM. I would wake up to go to the washroom and I could not lie down because of a feeling that I cannot breathe. I would sit in a chair for 1-2 hrs and then lie down and fall asleep. I was tested for the COPD and asthma, all negative and bymy cardiologist for the possible heart failure, also negative. Finally my family doctor sais that I am probably suffering because my bodily liquids get repositioned during the first sleep period and then they put pressure on my lungs until I sit for a while . It seems to fit my symptoms, especially since I am having the same feeling when I wake up in the morning and my additional body weight in the mid section seems to exert the similar pressure on my lungs. Do you have some advice for me, should I go to my cardiologist with this possible explanation? Thank you very much. Sincerely, XXXXX, P.E. (Age 76)

I could send you:
- The latest report from my cardiologist
- The latest angiogram diagram from 2011, and
- The latest blood test from 2015,
but I don't know how to scan them. However, if you have a fax, I can easily fax them to you. Please advise.
Answered by Dr. Ilir Sharka 4 hours later
Brief Answer:
I would eplain as follows;

Detailed Answer:
Hello Miodrag!

Welcome on HCM!

I passed carefully through your medical history and would like to explain that the most likely condition leading to your actual clinical scenario seems to be heart failure.

The above conclusion is supported by the fact you have shortness of breathing worsening when lying down; limbs edema; a previous history of myocardial infarction and repeated coronary revascularisation procedures.

Furthermore, alternative causes of shortness of breathing are excluded (COPD, asthma).

Coming to this point, it is necessary to carefully review a recent cardiac ultrasound and some additional tests:

- chest X ray study,
- complete blood count,
- BNP and NT-proBNP,
- PCR,
- BUN & creatinine,
- blood electrolytes level,

If heart failure is confirmed, then diuretics should be started to an adequate daily dose in addition to vasodilators, etc.

You can make photos of your latest cardiac tests by utilizing a smart phone or digital camera and subsequently upload them to your computer and in our site.

Hope you will find this answer helpful!

I remain to your disposal in case of any further uncertainties.

Kind regards,

Dr. Iliri

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

The User accepted the expert's answer

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