HomeAnswersPulmonology (Asthma Doctors)cardiac asthmaInspite of medications, I am not relieved from chest tightness. Is it COPD?

What is the treatment for chest tightness?

Share

The following is an actual conversation between an iCliniq user and a doctor that has been reviewed and published as a Premium Q&A.

Medically reviewed by

Dr. Vinodhini J.

Published At March 11, 2020
Reviewed AtApril 17, 2024

Patient's Query

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.

Hello,

Welcome to icliniq.com. 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.

Patient's Query

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.

Hi,

Welcome back to icliniq.com. 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.

Patient's Query

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.

Hello,

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

Same symptoms don't mean you have the same problem. Consult a doctor now!

Dr. Shitla Prasad Upadhyay
Dr. Shitla Prasad Upadhyay

Pulmonology (Asthma Doctors)

Community Banner Mobile
By subscribing, I agree to iCliniq's Terms & Privacy Policy.

Ask your health query to a doctor online

Pulmonology (Asthma Doctors)

*guaranteed answer within 4 hours

Disclaimer: No content published on this website is intended to be a substitute for professional medical diagnosis, advice or treatment by a trained physician. Seek advice from your physician or other qualified healthcare providers with questions you may have regarding your symptoms and medical condition for a complete medical diagnosis. Do not delay or disregard seeking professional medical advice because of something you have read on this website. Read our Editorial Process to know how we create content for health articles and queries.

This website uses cookies to ensure you get the best experience on our website. iCliniq privacy policy