QuestionHi there, my name is Heather and I am a 28y/o female, and a critical nurse as well who is completely bewildered and frustrated with a bizarre medical presentation that I need help on. I presented to the ER about 3 weeks ago with pretty severe SOB and tachycardia (ST in the 130s-150s). A CT arteriogram was done which was completely normal and I was sent home. I presented to my PCP the following day with continued SOB and tachycardia with minimal exertion. I walked around his office at a normal pace and was incredibly SOB and tachycardic in the 130s. I am a runner, so this does not make sense! Since that time, I have been to see a pulmonologist (of which asthma was ruled out, my PFTs were normal), an ECHO yielded normal results, and my bloodwork (CBC, chem panel, throid panel) all were normal as well. I am concerned that I could have some sort of heart condition and I am nervous about this as no one is giving me answers. I have even been formally evaluated for anxiety and panic disorder of which I have no evidence for at all. I was placed on a small dosage of ativan several weeks ago to see if it would help with the SOB and it really didn't work at all, other than make me sleepy. I am still SOB, tachycardic with exertion, and I occassionally feel a burning sensation in my chest. I feel a sense of breathlessness ...I just can't seem to catch my breath and I am yawning pretty consistently. Is this just my body's way of trying to get in more air when I am SOB? I have been having pretty severe sx at night and have been restless and SOB upon waking in the morning. When I was at the pulmonologist's office last week, everything looked okay to him and he told me that I didn't necessarily need further testing. After walking briskly outside for about 5 mins, my O2 sats dropped to about 96% (not horrible but still a drop) and I was tachycardic in the 130s. My PCP was initally concerned with pulmonary hypertension, however, he said that my echo looked okay and that it really didn't reveal any signs for PH. Upon doing my own research (and of course not really getting anywhere), it seems to me that SOB is usually associated with either a cardiac or respiratory anomaly. I am not one to be sickly or even go to the doctor, but I feel lousy, very fatigued, and not myself at all. Do you think it is possible that I have an undiagnosed cardiac problem? I am writing because I am clearly concerned and no one is giving me answers as to what is causing this unexplained SOB. I do feel okay at times ... I am actually feeling well right now and not SOB, but it seems like I am SOB most of the time, especially when up and doing things. Do you have any advice for a perplexed and very frustrated young woman?
Sincerely,
Heather
AnswerFirst of all, when this does get figured out, please email me and let me know what the diagnosis is. (drlipo@hotmail.com) We use FAINT---- Functional, Anatomical, Inflammatory, Neoplastic, Traumatic as categories to start with a sign/symptom complex. Some of the big ones (potentially dangerous) have been eliminated, ie., the CT of the chest, wit contrast to look for pulmonary embolism. Anemia, Thyroid testing- all good. ECHO- for this purpose- normal. How about the possibility of poisoning??? specifically, carbron monoxide.
Good luck with it.......
