Creator: Dr. Kartik Sood
Published: 2016-08-27T12:19:24-04:00

Patient's Query

Hi doctor,

I am a girl of 20. My height is 167 cm and weight is 75 kg. Over the past one week, I am having high discomfort and pain in my right chest when I breathe. The pain radiates to the right shoulder and right arm too. When I sneeze or blow my nose up, the pain is severe. I cannot explain this as a sharp pain, but there is a high discomfort. I fear of taking long breaths and so I take short breaths. If I do some physical activity, then this starts hurting me a lot. I become so tired and I wanted to take a short nap to recover. When I climb the staircase or if I talk continuously, then I keep panting for a while or feel short of breath. I do not feel the pain when I touch. I do not remember doing any heavy physical activity as a cause for this pain. Initially, I thought this would be a gastric problem, but my bowel movements are all as usual. Actually, for the past seven months, I have been having frequent throat infections, which resulted in bronchitis every time. I suffered with wheezing too during bronchitis. I have had breathing problems when my wheezing was severe. At those times, I used to have pain in my left chest. We took a chest x-ray, which was normal. Last bronchitis appeared 15 days ago. Now, I am in homeopathy treatment as too much of antibiotics made me sick. I wanted to know the reason for this sudden discomfort in my chest. Please give me some advice on the same.

Answered by Dr. Kartik Sood

Hi,

Welcome to icliniq.com.

As you have a history of frequent chest infections in the past, which were associated with wheezing, secretions and fever as well, I would suggest you to consult a pulmonologist or a chest physician in person.

Your symptom of chest pain, which increases on deep respiration seems like a pleuritic pain or a neuropathic pain. So, possibilities have to be ruled out.

If your physician suggests a HRCT thorax (high resolution computed tomography), then it can rule out other abnormalities as well if x-ray does not reveal much.

As per your history I can think of aspergillosis (allergic reaction to fungus), pleural effusion, sequelae of some disease which have been resolved and bronchiectasis.

For now, you can take some analgesics like Paracetamol to get rid of pain.

The Probable causes:

1. Aspergillosis.
2. Pleural effusion.
3. Sequelae of some disease which have been resolved.
4. Bronchiectasis.

Investigations to be done:

Chest x-ray, ECG, HRCT thorax and CBC.

Preventive measures:

Keep away from dust.

Regarding follow up:

Revert back with the reports to a pulmonologist online.---> https://www.icliniq.com/ask-a-doctor-online/pulmonologist

Patient's Query

Thank you doctor,

I shall take a chest x-ray soon and meet my physician. My chest pains when I bend. Also, I yawn so frequently. What could be the reason for me looking so tired? I am not able to talk to a person continuously. Fatigue is just ruling me.

Answered by Dr. Kartik Sood

Hi,

Welcome back to icliniq.com.

I completely understand that it is some bacterial infection going on, which makes you tired and causes fatigue. The reason may be the same.

Usually, all your previous symptoms and what you have told me now appears to be effusion or post-infective sequelae. So, the best way to rule out or to reach to a diagnosis is to get yourself examined.

Do not get stressed. You are young, so possibilities of some common diseases are more.

I wanted to know whether you had tuberculosis in the past. Symptoms of pain are going more towards post infective bronchiectasis.

For further information consult a pulmonologist online --> https://www.icliniq.com/ask-a-doctor-online/pulmonologist

Patient's Query

Thank you doctor,

No, I did not have tuberculosis in the past. I had only bronchitis, which will be mostly fever, cough, vomiting bloody mucus and wheezing. I am attaching you all my past prescriptions and the chest x-ray, which I took when I had pain in my left chest. I shall meet my physician soon and take a chest x-ray and send you the result.

Answered by Dr. Kartik Sood

Hi,

Welcome back to icliniq.com.

It was a great help with the past x-ray and prescriptions (attachment removed to protect patient identity).

Now, I can tell you that probably you are suffering from allergic inflammation of bronchus or you can say complicated bronchial asthma.

The inhalers, you are taking are good and anti-allergies are fine. Of course, Acebrophylline will help.

Now, you can ask your pulmonologist regarding the chances of allergic bronchopulmonary aspergillosis. Symptoms of bronchitis, wheeze, hemoptysis, breathlessness are towards ABPA. Bronchiectasis, bronchial asthma, bronchitis and chest pain all are features of the same disease.

Now your chest physician may suggest you some tests like spirometry, aspergillus skin test, eosinophil count, absolute eosinophil count, serum IgE and IgG specific for aspergillus. If these come positive, then corticosteroid is the drug of choice.

Before taking any medications, visit a pulmonologist and discuss all the possibilities. You will be better soon.

For further information consult a pulmonologist online --> https://www.icliniq.com/ask-a-doctor-online/pulmonologist

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