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Q. My mother has chest pain and breathlessness. What do we do?


 

Hello doctor,

My mother has the following complaints. She is feeling rotating chest pain. She has breathing difficulties while walking. I have uploaded her ECG for further investigations.


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Dr. Anshul Varshney
M.B.B.S., M.D. MEDICINE
Critical Care Physician, Diabetology, General Medicine, Internal Medicine, Medical Gastroenterology,

Hello,

Welcome to icliniq.com.

I have studied her ECG (attachment removed to protect patient identity) and there is no significant abnormality. I would like to know the following details regarding breathlessness and chest pain that she gets:

  1. Is it during walking or sitting position?
  2. Is it continuous or intermittent?
  3. Is there any previous history of diabetes or hypertension?
 

Thank you doctor,

Here are the answers to your questions.

She is diabetic for the past 10 years and not under control. Her blood sugar level is 200/250 mg/dL. As a part of her profession, she had been sitting in a chair for more than 18 hours per day. But nowadays, she used to spent only 8 to10 hours per day and that too twice or four times a month. After a long walk she will be panting, not so high but I can spot that out when she speaks. She is not getting proper sleep too.

 

Dr. Anshul Varshney
M.B.B.S., M.D. MEDICINE
Critical Care Physician, Diabetology, General Medicine, Internal Medicine, Medical Gastroenterology,

Hello,

Welcome back to icliniq.com.

Diabetes is the biggest complication creating disease. So, she should take her medicines regularly to maintain her blood sugar levels.

If she is less mobile, the possibility of cardiac issues and deep vein thrombosis increases. We should not rely on ECG in her case. She should get a Tread Mill Test (TMT), echo, and doppler legsdone. Moreover, she should be given blood thinners in the form of antiplatelet drugs like Aspirin. Your doctor would start her with an assumed dosage and will modify the medicines based on her blood sugar values. She would definitely require weight reduction.

There are two ways of diabetes management:

  1. Lifestyle changes - Includes diabetic diet, daily exercise, cholesterol, and weight management.
  2. Drug therapy - If blood sugars are so high, they cannot be well controlled on any dietary measures. So the medicines are required based on the blood sugar levels.

I would advise you to get her following investigations done:

  1. HbA1c.
  2. Fasting lipid profile.
  3. Serum creatinine.
  4. Urine for microalbumin.

Stay healthy.

 
 
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