What does chest tightness mean in a 50-year-old?

Hi doctor,

I am a 50-year-old female with a history of childhood asthma that was virtually a non-issue 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 am 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.

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.

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.