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What could cause chest pain and breathlessness?

This Premium Q&A, reviewed and published, features a real conversation between an iCliniq user and a physician.

Patient's Query

Hello doctor,

My mother has the following complaints: she is experiencing rotating chest pain and has difficulty breathing while walking. I have uploaded her ECG (electrocardiogram) for further investigation.

Please advise.

Hello,

Welcome to icliniq.com.

I understand your concern.

I have reviewed her electrocardiogram (attachments removed to protect the patient’s identity), and there are no significant abnormalities. I would like to know the following details regarding her breathlessness and chest pain: does it occur while walking or in a sitting position? Is it continuous or intermittent? Does she have any previous history of diabetes or hypertension?

Thanks and regards.

Patient's Query

Hello doctor,

Thank you for your reply.

Here are the answers to your questions: She has been diabetic for the past 10 years and is not well-controlled. Her blood sugar levels range from 200 to 250 mg/dL. As part of her profession, she used to sit for more than 18 hours a day, but now she spends only eight to 10 hours per day, and that is only two to four times a month. After a long walk, she becomes somewhat breathless; it is not severe, but I can notice it when she speaks. She is also not getting proper sleep.

Hello,

Welcome back to icliniq.com.

Diabetes is a significant complication that can lead to various health issues. Therefore, she should take her medications regularly to maintain her blood sugar levels. If she is less mobile, the risk of cardiac issues and deep vein thrombosis increases. We should not rely solely on the ECG (electrocardiogram) in her case; she should undergo a treadmill test (TMT), an echocardiogram, and a Doppler ultrasound of her legs. Additionally, she may need blood thinners in the form of antiplatelet drugs like Aspirin. Your doctor will start her on an initial dosage and adjust the medications based on her blood sugar values. Weight reduction is definitely necessary.

There are two approaches to diabetes management: lifestyle changes and drug therapy. Lifestyle changes include a diabetic diet, daily exercise, and cholesterol and weight management. If blood sugar levels are very high, dietary measures alone may not be sufficient, and medications will be required based on the blood sugar readings.

I advise you to get the following investigations done: HbA1c (glycated hemoglobin), fasting lipid profile, serum creatinine, and urine analysis for microalbumin. Stay healthy.

I hope this helps.

Thank you.

Medically reviewed byDr. K. Shobana

Published At July 8, 2015
Reviewed AtSeptember 20, 2024

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