Inspite of medications, I am not relieved from chest tightness. Is it COPD?

Q. Will SVF fat cell treatment for OA result in chest tightness and COPD?

Answered by
Dr. Shitla Prasad Upadhyay
and medically reviewed by Dr. Vinodhini. J
This is a premium question & answer published on Mar 11, 2020 and last reviewed on: Sep 11, 2023

Hi doctor,

I am a 50-year-old female, with a history of childhood asthma, that was virtually a nonissue in my adult life until three weeks ago. I had a recent stromal vascular fraction (SVF) adipose stem cell treatment for osteoarthritis (OA) with a cold on board. I felt tight chested then but not bad enough to take my Ventolin. A few days later, I developed a persistent tight chest and difficult exhalation that led to a respiratory admission for ?asthma or reactive airways. In spite of Prednisolone, Seretide, Ventolin, and Atrovent, I do not feel better. I am unable to work and doing very minimal things around the house because of the severity of the symptoms. My mother had chronic obstructive pulmonary disease (COPD). I am frightened this is COPD and I am terrified actually. I am also scared that maybe the stem cells have caused an adverse lung reaction. I cannot continue to live like this. I have had a normal (computed tomography) CT pulmonary angiogram (CTPA), normal chest EZ-ray (CXR), normal echo, no growth in my sputum, and apparently a normal-looking lung function test that might be indicative of asthma (different people tell me different things). Please help.



Welcome to I have gone through your symptoms and investigations thoroughly and your treatment records. (attachment removed to protect patient identity). First of all, it is not a COPD (chronic obstructive pulmonary disease) and asthma as suggested by normal pulmonary function tests and normal chest x-ray. It is also very unlikely due to stem cell reaction as chest x-ray is normal. I have reasons to suspect that symptoms are not due to lungs rather due to heart the condition is known as cardiac asthma. I want to know one thing do you have swollen leg on both sides and are you on any antihypertensive agent. The probable cause is congestive heart failure. Investigations to be done are echocardiogram (ECG), and Echocardiography. The differential diagnosis is atypical lung infection. The probable diagnosis is cardiac asthma. The treatment plan include Tablet Aldactone 50 mg (Spironolactone) one tablet thrice a day for five days. Tab Monteluekast 10 mg. 1 tab once a day at bed time for 2 weeks. The preventive measure is to raise your head side while sleeping. Upload your echo and other reports.

Thank you doctor, No, my ankles are not swollen and I am not on any antihypertensives. I have been under the care of a cardiologist because of a history of premature death on my father's side from cardiac causes. My brother died from an myocardial infarction (MI) at 37 years. I have a known aortic murmur, and a recent echo apparently is fine, with no deterioration of the valve. I have been having palpitations for many years, which on Holter, turned out to be premature ventricular contractions (PVCs). Two days after the stems, I had an episode of rapid atrial fibrillation (AF) which reverted with iv magnesium. My cardiologist does not feel I need to be medicated at this stage. Follow ups at this stage are a Holter monitor, and a stress test. I will say that I sleep fine. It is the only time I feel normal even lying flat. I was given Diazepam in the hospital to relax. It did that and relieved the chest tightness, but obviously I do not want to get into the habit of taking this without getting to the root cause of the problem. So, how is cardiac failure diagnosed? I actually forgot to mention that my CXR stated that I have a slightly enlarged cardiac silhouette but not sure of its clinical significance.



Welcome back to Many a time cardiac failure is diagnosed on a clinical basis, x-ray, echocardiography, and electrocardiogram might turn to be normal. As there is no ankle swelling and you sleep fine at presently no need of giving Aldactone. This chest tightness is very likely due to cardiac cause. I advise you to take: 1. Tablet Montelukast 10 mg one tablet at 8 PM daily for two weeks. 2. Isosorbide mononitrate 10 mg one tablet at 8 AM and 4 PM. 3. Reduce salt in the diet. 4. Tablet Alprazolam 0.25 mg at bedtime for two weeks. Please do an echocardiography and NT Pro BNP (B-type natriuretic peptide) test and echocardiogram (ECG). Please upload all your reports for review. Hope you will get well soon.

Thank you doctor,

I have done an echo which was normal as was the last echocardiogram (ECG) which showed I was in normal sinus rhythm. I will look into the blood test when I get to speak to my cardiologist.



Welcome back to Could you please upload your reports so that I can go through it. Please provide me information regarding your eosinophil count.

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