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Q. What causes shortness of breath and stomach cramps?

Answered by
Dr. Muhammad Zohaib Siddiq
and medically reviewed by iCliniq medical review team.
This is a premium question & answer published on Mar 05, 2021

Hi doctor,

My wife is suffering from anterolateral ischemia and atherosclerosis of the thoracic aorta. I have attached the reports kindly comment.

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#

Hi,

Welcome to icliniq.com.

Thanks for the query.

The patient has a moderately reduced left ventricular ejection fraction (40%).

Aortic and mitral valve thickening and calcification are age-related, and it is considered a normal age-related finding.

Regarding reduced ejection fraction, the patient should take medicines for heart failure.

Please give me a history of the patient? Did she ever have a heart attack? What medicines is she currently on? Has she ever had Angiography?

Please tell me so that I can guide you accordingly.

Hi doctor,

She has never had any heart attack nor heart failure.

She is currently taking Amlodipine, Diclofenac, Simvastatin, Omeprazole, and heart health supplements.

#

Hi,

Welcome back to icliniq.com.

She should take the following medicines:

1. Tablet Aspirin 75 mg daily one tablet in the day.

2. Tablet Simvastatin 20 mg daily at night.

3. Tablet Carvedilol 6.25 mg twice a day.

4. Tablet Enalapril 2.5 mg twice a day.

When she has shortness of breath, she can take

5. Tablet Furosemide 40 mg once or twice a day.

If she is currently healthy, she should have CT myocardial perfusion imaging for reversible ischemia. If reversible ischemia is detected, then angiography and revascularization.

Does she have diabetes?

Hello doctor,

She is experiencing shortness of breath often and stomach cramps. She has not been tested for diabetes yet.

#

Hi,

Welcome back to icliniq.com.

From the attached file (attachments removed to protect the patient's identity) echo findings are suggestive of ischemic left ventricular dysfunction. May be she had silent heart attack in past. If she was normal and suddenly has shortness of breath, probably she recently had heart attack. How to know this? Troponin I levels in blood will indicate attack is recent (within 15 days or so). Please give her the above medicines prescribed, these all are indicated. Also have fasting blood sugar and random blood sugar levels done to know whether she has diabetes or not. Diabetes is a major risk factor for cardiac events. ECG should also be done.


Investigations to be done:

ECG, Troponin I levels, blood sugar levels.

Treatment plan:

As prescribed above. It may be modified from time to time depending upon blood pressure and symptoms.

Hello doctor,

Can she still take Amlodipine and Diclofenac together with your prescribed medicines? What foods should she avoid eating?

#

Hi,

Welcome back to icliniq.com.

Yes, Amlodipine can be taken. It is for hypertension. Enalapril is also for hypertension as well as for hearts protection. If you take both, then monitor blood pressure cautiously. Diclofenac is for musculoskeletal pain. Can be used cautiously in cardiac patients. Should not be used daily and should not be used in high dose. NSAIDs (nonsteroidal anti-inflammatory drugs) can cause fluid retention, and also can cause kidney damage if taken for prolonged period and in high doses. For pain Paracetamol or Tramadol plus Paracetamol is better.


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