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Dr. Andrew Rynne
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Dr. Andrew Rynne

Family Physician

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What causes shortness of breath?

Answered by
Dr.
Dr. Chobufo Ditah

General & Family Physician

Practicing since :2009

Answered : 6250 Questions

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Posted on Wed, 2 Apr 2014 in Medicines and Side Effects
Question: Is this a pulmonary embolism from DVT? 12 weeks ago had strep throat, stayed in bed for about 3-4 days. A week later shooting pains in my thighs and numbness/tinging in my face. A few weeks later shortness of breath that appears to be increasing. This week my resting pulse rate is around 100 and when I get up and walk around it goes up to around 120 just walking. I've had PFT and it came back okay, chest xray, echo to rule out heart problems and still breathing problems are there.
doctor
Answered by Dr. Chobufo Ditah 2 hours later
Brief Answer: This is not pulmonary embolism Detailed Answer: Hi and thank you so much for this query. I am so sorry to hear about this difficult breathing you have been reporting and the increased heart rates you have reported. The cause of these symptoms may not have been identified but I am pretty convince this is not any form of pulmonary embolism from a DVT. With all these investigations already done to investigate for possible lung and heart disease without any abnormal findings, it would be very unlikely that we are missing something here. Back to PE, you not to present with the risk factors for this to develop. Having been in bed for 4days could have been a risk factor but nothing happened during this time. No DVT would be silent to show up when the factors are almost gone. The typical symptom of chest pain is also lacking and with repeatedly normal tests, I will walk away and not even think of this as the possible cause of my breathing difficulties. Heart disease after a sore throat in the form of rheumatic heart disease is not an impossibility. But you already mention that you have been completely screened for possible heart disease. Did your doctor mention this post strep sore throat complication to you and ruled it out? If he didn't, please kindly ask him about it. Have you had any EKG already? Breathing difficulties are often cause by problems of he lungs, heart, or blood. If the heart and lungs have been cleared of every possible pathology, then we may want to look at the blood and especially the red blood cells. Anemia can be the cause of these symptoms. Have you had the hemoglobin numbers checked? what were the numbers? Have you been able to return to work? are there any other symptoms of concern to you?And when you say you are having breathing difficulties, what is that supposed to mean? Does it mean that you get easily exhausted each time you try to do something or is it like you have difficulties getting air in and out of the lungs? I hope this addresses your query fully. If you have any related questions or need more information or clarifications, please feel free to forward those questions to me and I will gladly address them. Thanks for using our services. Dr. Ditah, MD.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Follow up: Dr. Chobufo Ditah 8 minutes later
Yes, I've had EKG. By breathing difficulties I haven't been able to exercise as much as I used to. Also it feels as if I can't take a deep breath, I'm shallow breathing through my mouth all day. If I close my mouth and try and breath through my nose it kind of feels like I'm holding my breath or that its harder to breath. Chest pain comes and goes throughout the day as does leg pain. When I lay down or sit still it appears to be worse. When I walk and blood is flowing through everything appears to be better I think. Breathing is still bad when walking but the rest is not. I had a PFT and all came back okay. Is there any sense to repeating PFT to see of breathing has decreased?
doctor
Answered by Dr. Chobufo Ditah 22 minutes later
Brief Answer: No need to repeat PFTs Detailed Answer: Hi and thanks for following up with me. There is no need to repeat these tests. what matters most is how you feel and numbers would not change that. Even if the tests were to show that all is normal with you not feeling better, it will not be very helpful. Have you ever had concerns about DVT before? These symptoms are so atypical that make e wonder if they are totally explained by something going on within the body or rather a deep concern about this illness. I am happy to hear the resting has improved. I will advice that you seek no immediate medical attention and let's monitor your symptoms to collect more information that may orient further investigations if need be. I will not be surprised i time provide answers to all the worries you have right now. If breathing through the nose with a closed mouth is difficult, then i will suggest you get the nasal passages examined for patency. I hope the sore throat didn't cause any blockage that may explain this difficulty. Also, try to breath as deep as possible so as to keep the lungs fully functional. Hope this helps. feel free to get clarifications and more information if need be. Dr. Ditah, MD.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Follow up: Dr. Chobufo Ditah 25 minutes later
ok thanks notjing specific points me to dvt jslust the shortness of breath Shortness of breath is worse by the week. Its affecting my life as a whole. I can't keep normal relations with friends or even do normal activities that I used to enjoy.
doctor
Answered by Dr. Chobufo Ditah 16 hours later
Brief Answer: Sorry about this Detailed Answer: Hi and thanks for this follow up. I am so sorry to hear about this worsening shortness of breath. To be honest, I will like your heart to be evaluated fully. There are just two main possible causes shortness of breath on exertion when the lungs have been cleared as in your case.. These are heart and blood disorders. I had asked whether you had a blood work up done and what the hemoglobin value was without nay success yet. I will suggest that you report this value to me if it is already available. An EKG gives ample information on the electrical activity of the heart but not the functional status of the heart. It would make sense if your heart can be evaluated with an ultrasound to tell whether the volumes of blood it receives and sends out are all normal. This would also provide enough information on whether we have any structural abnormality of any gross dysfunction of the pumping system. Depending on the findings of these exams, you would be oriented to the right quarters that can continue this process. Let me know what the initial findings are and we would be able to make the right decisions on how to tackle this problem. I wish you well. Dr. Ditah, MD.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Follow up: Dr. Chobufo Ditah 9 minutes later
I have hgb levels of 17. ive had an echocarduogram and stress test all came back normal...
doctor
Answered by Dr. Chobufo Ditah 24 minutes later
Brief Answer: A hemoglobin of 17??? Detailed Answer: This seem a lot more serious than it really sounds. With every exam turning back with no contributive findings that can lead to the diagnosis and management of this problem is even more frustrating to all. Please, hemoglobin of 17 seems to be some what high. If you have had previous blood tests, I will like these numbers to be compared to the others to see if there has been a great change. If you do have access to them, I will like to have the numbers for comparison. The numbers may increase in response to low oxygenation by the lungs or indicative of some other disease conditions like polycythemia. Are there any other symptoms of concern to you beside this? Just vomit anything you can think of to e and let me see whether I can make some sense out o it. Wish you well. Dr. Ditah, MD.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Follow up: Dr. Chobufo Ditah 2 hours later
Prior to all this HGB levels were around 16.5 so not much of an increase. My heart rate is increased around 100 at rest. When I get up it goes up to 120 just walking around. The leg pains are so sore most of the day, especially when I'm sitting, Immense pains in my legs at the top of my thighs a kind of burning I feel most of the day especially when sitting down.
doctor
Answered by Dr. Chobufo Ditah 1 hour later
Brief Answer: Sorry for all this! Detailed Answer: Hi and thanks for this follow up information. I agree with you that you have not had any significant change in this hemoglobin levels to suggest any concerning illness. Your symptoms do not point to a very clear diagnosis. I will suggest that you get consulted and fully examined by a doctor who may be able to pick up even more suggestive signs and clues on physical examination that are not immediately evident and help in understanding this problem even more to advance towards proposing real solutions. I will suggest that your doctor starts by proposing treatment for the various symptoms while he goes on to look for the cause of this problem. I would have been happier if I could do this in person but this is just impossible because of our distance apart. I can only wish that you get something that would make life a lot better and worthy of. I wish you well. If there is any further advice or information that you would like me to provide, please let me know. Dr. Ditah, MD.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Follow up: Dr. Chobufo Ditah 11 minutes later
Thanks for your help. I have had doctors examine me physically and none find anything wrong. They're thinking its all anxieties but I'm almost certain that this is not the case.
doctor
Answered by Dr. Chobufo Ditah 19 hours later
Brief Answer: I a so sorry to hear about this Detailed Answer: Hi and thank you so much for sharing this pain with me. I understand how disturbing this can be when you are not feeling well and yet your physicians are unable to identify a palpable cause that can be addressed and followed through to provide lasting solutions to you. With your doctors saying this was more of anxiety than something else, did they follow through to treat your for this anxiety? If not I will suggest that they try to do so and if for real that is the cause, you would feel a lot better after treatment. If you should not feel better after that, it would be another way to tell that this is definitely not he cause and lead to more investigations. I hope something is done soon to help you with this. I am so sorry I am that far away to have offered my best to see whether I could do more than just this. I wish you the best of health. Dr. Ditah, MD.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Follow up: Dr. Chobufo Ditah 2 hours later
I've been on many anti anxiety meds none helped...
doctor
Answered by Dr. Chobufo Ditah 1 hour later
Brief Answer: What medicatiosn did you try and for how long Detailed Answer: Hi and sorry to hear about this rather difficult trend of events that you have been going through. What medications have been tried and for what duration of time? I will go through and see if there is anything I could have done otherwise in this regard. I hope to hear from you. Dr. Ditah, MD.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Follow up: Dr. Chobufo Ditah 42 hours later
I was on Cymbalta for 5 years. I've been on xanex 1 MG and that didn't help, adavan 2 mg, Klonopin, Neurontin. I'm now on Neurontin and Prestiq and they seem to help relieve the anxiety a bit but breathing troubles still seem to be there as well as constant leg pains.
doctor
Answered by Dr. Chobufo Ditah 5 hours later
Brief Answer: Thanks Detailed Answer: Hi and thank you so much for this follow up precision. I can see you have not spared any efforts to try just any drugs that your doctors have recommended. I feel your pain and I share your frustrations. because you have reported that the recent medications seem to be helping, I will suggest that you just stick to them for some while and see whether they get fully functional and offer more help. At times, we need to stay on these medications a little longer before noticing a complete benefits. There is really no new medications I should be adding to this list at this time. I wish you well. Dr. Ditah, MD.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Follow up: Dr. Chobufo Ditah 1 minute later
ive bewn on pristiq for 4 weeks with no change synptoms getting worse...
doctor
Answered by Dr. Chobufo Ditah 4 hours later
Brief Answer: I will suggest you stop the medication Detailed Answer: I am sorry to hear about this rather disappointing result fro using this medication for the past 4weeks. 4weeks is enough time for any medication that can be of help to at least some some positive signs. With no positive impact for the past 4weeks, there are very little chances that this drug would be able to do any significant improvement in your symptoms. Ask your whether he would like to continue with this medication or not. Like I mentioned before, your symptoms are not too typical of any specific disease condition that can guide me to make a call right now without more information. I will prefer a single doctor to help intervene and try all the available options to ensure a closer follow up that should help decipher what's best for you. I hope this helps. I wish you well. Dr. Ditah, MD.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Follow up: Dr. Chobufo Ditah 3 hours later
Thanks, I was back into my internest now that I have seen 4x and has run most of the tests. He can't come up with anything and is basically stating that its all anxiety and referred me back to my Psychologist and Psychiatrist for more counceling as well as for them to change meds if necessary. I may seek another opinion with another doctor as I still don't feel this is all anxiety and my breathing is getting worse by the week. He thought this was all a cyclical cycle of anxiety driving the problems to get worse. I'm not so sure that is the case and want to take a 2nd opinion before long. Thanks for your followup you have been helpful in your information.
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