Hello doctor,
A couple of months ago, I started feeling tightness in chest, shortness of breath, and overall fatigue. I went to a walk-in clinic, they did an EKG, and everything was fine. They asked me to follow-up with a physician. The nurse conducted a complete blood test and a chest x-ray, and everything came out to be normal. She still recommended me to see a cardiologist for my heart palpitations. I saw the cardiologist, and he did an ultrasound of the heart. He put a Holter monitor on me for a day. All the results came back normal, but I was still having these issues. I feel shortness of breath, chest tightness, and a heavy, dizzy feeling on the back of my head intermittently throughout the day. The heaviness is more pronounced after having meals. Because I felt a bit of reflux too, I went to a gastroenterologist, who confirmed I have acid reflux, and the doctor put me on Omeprazole twice a day. For the shortness of breath issue, I saw a pulmonologist, who said I have asthma after they performed a PFT. He gave me Corticosteroids to use twice daily, and short-acting beta-agonist in the case of an asthma attack.
I have been using the Corticosteroids since four days, but I do not feel my condition getting any better. The shortness of breath comes and goes intermittently, and becomes pretty pronounced when I climb a small flight of stairs, or even when I just walk for some time. I researched more about the causes of these symptoms on the internet, and I found a few serious diseases like pulmonary hypertension and pulmonary fibrosis, which have very similar symptoms to what I am experiencing. Note that till date, I have never had a proper asthma attack. This is coupled with the fact that it has been four days, and I do not feel like the Corticosteroids are helping as yet. I am a bit anxious if I have other serious issues like pulmonary hypertension or pulmonary fibrosis.
Are the symptoms that I am experiencing typical of an asthma patient? Also, considering I have done a chest x-ray and a heart ultrasound and put on a Holter for a day, is it still possible that the serious diseases would have gone undetected? Thanks.
Hello,
Welcome to icliniq.com.
My impression about your illness is gastritis and reflux disease, which is leading to reflux of acid into the lungs causing bronchoconstriction. This bronchoconstriction leads to shortness of breath and asthma-like pattern on the pulmonary function test (PFT). The probability of heart disease is less, as your age and symptoms are not very compatible. Your ECG (electrocardiography) is normal. Heart symptoms with typically come with exertion and relieves with rest and evaluation are negative. Regarding thepossibilities of pulmonary hypertension and fibrosis, I am not for those. Because it is commonly seen females and elders, more importantly, your PFT and ECG are normal, so it rules that out.
I suggest you try the following:
1) Avoid fatty, oily, and spicy diet.
2) Go for a walk after having food, instead of taking rest.
3) Have multiple small meals, instead of heavy meals.
5) Have regular sleep habits and avoid stress.
6) Consume a lot of green leafy vegetables, fruits, etc.
7) Elevate your head by using pillows during rest and sleep.
I suggest trying tablet Pan DSR (Pantoprazole and Domperidone) 40 mg, three times a day for two weeks, along with a prokinetic, which helps in propelling the acid forward. If there is still no adequate relief, then add syrup Sucral O (Sucralfate and Oxetacaine), two teaspoons, three times a day for a week.
You can discontinue the inhaler and steroids. Hope this helps you, and get back if you have any doubts.
Regards.
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