I get shortness of breath and chest tightness after taking Hydroxychloroquine for fever. Why?

Question

Hello doctor,

I have manageable shortness of breath and chest tightness, but no cold. My X-rays are clear, and the ECG is also normal. My BP seems high at 140/90.

Mainly, I am unable to breathe normally and feel a little short of breath all the time. I am currently taking the last doctor’s doctor-prescribed medication. I understand it may be difficult for doctors to find the exact cause immediately, but I am hoping for the best. Right now, I believe more in my daily food than in medicines.

Initially, it started with a cold last month. I took homeopathic tablets and developed a fever of 99°F, which lasted for three days. The doctor advised me to visit the nearby government medical college hospital. I went there and also took a COVID test, which came back negative. The hospital prescribed Hydroxychloroquine and Rantac tablets. After taking them, my fever subsided, and I felt fine.

However, early this month, I suddenly developed shortness of breath. I am not sure if it was due to a food allergy. That day, I had eaten two eggs and four pieces of jackfruit. I visited the hospital again, and they gave me two more days of Hydroxychloroquine. Since then, I have been experiencing shortness of breath without any cold or cough. The doctor says all my reports are normal, but they are still unable to find the cause.

Please help.

Thank you.

Answer 1

Hello,

Welcome to icliniq.com.

I understand your concern.

Based on your description, you are experiencing shortness of breath and chest tightness without cough or cold. These symptoms can result from several conditions:

Anxiety often causes chest tightness, shortness of breath, rapid heartbeat, sweating, and nausea.
GERD (gastroesophageal reflux disease) occurs when stomach acid flows back into the esophagus, leading to chest tightness, shortness of breath, and difficulty swallowing.
Muscle strain can develop from physical activity, such as lifting or twisting, and cause similar discomfort.
Costochondritis. Inflammation of the cartilage connecting the ribs to the breastbone, resulting in chest tightness and pain.
Other possible causes peptic ulcer disease (PUD), valvular heart disease, pulmonary hypertension, esophageal rupture, pericarditis, or hiatal hernia, can also present with these symptoms.

Recommended investigations:

ETT (exercise tolerance test) and echocardiogram to assess heart function.
Upper GI endoscopy or barium swallow test to evaluate for GERD or other gastrointestinal causes.
CBC (complete blood count) to rule out infection or anemia.
FEV1 (forced expiratory volume), spirometry, ABG (arterial blood gas) analysis, and reversibility test to evaluate lung function and confirm or rule out bronchial asthma.

Treatment will depend on the underlying cause identified. Follow-up with your physician or pulmonologist for further evaluation and management is advised.

I hope this helps you.

Thank you.

Answer 2

Hi,

Welcome back to icliniq.com.

I have gone through your case several times and found nothing significant. You have a rapid heartbeat, sometimes high BP (blood pressure). I think it may be due to anxiety or tension; maybe you suffered from acid reflux, too. According to the last prescription, you are on Rabeprazole, Domperidone, and analgesics like Tramadol, Paracetamol, etc.

According to your statement, I think you have been suffering from anxiety with acid reflux that causes your chest tightness, shortness of breath, rapid heart rate, etc. You can take syrup. Gaviscon (two teaspoons four times daily after a meal), an anxiolytic like Clonazepam or Bromazepam once at bedtime for anxiety and insomnia, along with your current medications.

No need to undergo any investigations under these circumstances. Please become mentally strong and strict on your current medications. I think that is enough for you now, and knock me in case of any other query.

I want to add something. You had taken Hydroxychloroquine for a fever. Some common side effects of this medication are chest pain or tightness, rapid heartbeat, anxiety, etc. Sometimes it also causes raised blood pressure among the rare complications; shortness of breath is one of them. So all of your present clinical features may have resulted from the side effects of Hydroxychloroquine.

I hope this helps you.

Thank you.