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I Have Wheezing, Chest Tightness , Rib Cage Pain, Right
Question: I have wheezing, chest tightness, rib cage pain, right hip joint pain. I didn't have my blood pressure medicine for about four days. How likely could this be a heart issue? I had a negative troponin and EKG in December and a normal BNP about a year ago.
Brief Answer:
I would explain as follows:
Detailed Answer:
Hello!
Welcome on - Ask a Doctor - service!
I understand your concern and would like to explain that your current symptoms need to be further investigated.
Wheezing and rib cage pain are important clues to suspect of a pulmonary disorder.
Coming to this point, considering your past medical history, a high suspicion may be raised regarding the possibility of a pulmonary embolism disorder.
May be, a lower limb vein thrombosis (denoted in this case by right hip joint pain) could be the source of a possible thrombus, that moving with the circulating blood flow through the right heart is finally anchored inside the pulmonary vessels tree.
This may be a life-threatening condition, and a clinical suspicion is sufficient to ask immediate medical assistance to the nearest ER service at your living area.
A cardiac ultrasound, D-dimer and immediate pulmonary angio CT scan are required to confirm or rule out this disorder. It may have important implications even to your heart.
So, I would advise to ask medical assistance ASAP and investigate first in this suspected disorder.
Hope to have been helpful to you!
Lat me know in case of any further questions.
Kind regards,
Dr. Ilir Sharka
cardiologist
I would explain as follows:
Detailed Answer:
Hello!
Welcome on - Ask a Doctor - service!
I understand your concern and would like to explain that your current symptoms need to be further investigated.
Wheezing and rib cage pain are important clues to suspect of a pulmonary disorder.
Coming to this point, considering your past medical history, a high suspicion may be raised regarding the possibility of a pulmonary embolism disorder.
May be, a lower limb vein thrombosis (denoted in this case by right hip joint pain) could be the source of a possible thrombus, that moving with the circulating blood flow through the right heart is finally anchored inside the pulmonary vessels tree.
This may be a life-threatening condition, and a clinical suspicion is sufficient to ask immediate medical assistance to the nearest ER service at your living area.
A cardiac ultrasound, D-dimer and immediate pulmonary angio CT scan are required to confirm or rule out this disorder. It may have important implications even to your heart.
So, I would advise to ask medical assistance ASAP and investigate first in this suspected disorder.
Hope to have been helpful to you!
Lat me know in case of any further questions.
Kind regards,
Dr. Ilir Sharka
cardiologist
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Thank you so much for responding. That was the last message I wanted to hear but I know I needed to hear it. I want to tell you that I did have a ct scan of the pelvis and abdomen about a little over a week ago and it said I had benign appearing sclerotic changes along both SI joints but I guess the lower ct with that finding still cannot rule ou a pe, right? Don't want to go because of Covid 19 but I will if I have to. I will prepare to call for a ride in a little bit.
Thank you, Dr. for your help. I took your advice and went to the ER, and unfortunately, I still don't feel well. I was given an ekg upon arrival, and an IV was started. A d dimer, and troponin as well as other basic blood tests were done. The troponin, d dimer, chest x-ray and ekg were normal but I did not receive a CT scan of the chest. Perhaps they did not want to expose me to more radiation but given my history, and would have felt more relieved if they had given me one. By God's grace and mercy, I'll be okay. I just hope to feel better soon. Something seems off about all of this. Does Covid 19 show up on chest x-ray? I don't believe I have Covid 19 but my chest and upper back feels very tight and pressurized, and still feel the right hip joint sensation
I'll seek more help if I need to do so. Thank God the other tests were normal.
I'll seek more help if I need to do so. Thank God the other tests were normal.
Brief Answer:
Opinion as follows:
Detailed Answer:
Hello again!
I wish that the suspicion about pulmonary embolism be never confirmed; anyways I had to inform you that such an alternative should be the first to become excluded when wheezing and chest symptoms are present.
Normal lab tests are a good news. I don't think there is anything suggesting Covid 19 in your case. So, nothing to worry about! Chest X ray study, complete blood count with leukocytes differential and blood oximetry rule out any acute pulmonary inflammation/infection.
I recommend your to keep staying physically active, take plenty of fluids and if symptoms persist, ask repeated medical assistance and a new testing review including cardiac ultrasound test.
Let me know in case of any further questions.
Wishing you a pleasant weekend!
Kind regards,
Dr. Iliri
Opinion as follows:
Detailed Answer:
Hello again!
I wish that the suspicion about pulmonary embolism be never confirmed; anyways I had to inform you that such an alternative should be the first to become excluded when wheezing and chest symptoms are present.
Normal lab tests are a good news. I don't think there is anything suggesting Covid 19 in your case. So, nothing to worry about! Chest X ray study, complete blood count with leukocytes differential and blood oximetry rule out any acute pulmonary inflammation/infection.
I recommend your to keep staying physically active, take plenty of fluids and if symptoms persist, ask repeated medical assistance and a new testing review including cardiac ultrasound test.
Let me know in case of any further questions.
Wishing you a pleasant weekend!
Kind regards,
Dr. Iliri
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Thank you very much for your help. I went and got the CT scan because I continued to feel bad. They said the CT scan was normal with no evidence of blood clots. I went to a different emergency room because I didn't feel comfortable going back to the same one. I had a fever so I was placed in a negative pressure room. A urinalysis just showed a little bit of bacteria in my urine so the doctor wrote a prescription for amoxicillin. And I was tested for covid 19 but I have to wait a few days for the results to come back. And While I know amoxicillin is a good antibiotic, I don't know why he chose amoxicillin for a uti. I've never been given amoxicillin for a uti. But I'm going to get my prescription filled because I know it can work on a wide range of things and it doesn't give me a lot of unbearable side effects. Thank you very much for all of your help.
Brief Answer:
You are welcome!
Detailed Answer:
Hello!
I am glad to hear serious pulmonary issues like PE have been excluded. The doctor's choice about the antibiotic therapy seems to be inclusive as Amoxicillin has beneficial effects on respiratory as well as urinary tract infections.
I wish your test results come negative and your clinical conditions improve soon.
Wishing you good health!
Kind regards,
Dr. Iliri
You are welcome!
Detailed Answer:
Hello!
I am glad to hear serious pulmonary issues like PE have been excluded. The doctor's choice about the antibiotic therapy seems to be inclusive as Amoxicillin has beneficial effects on respiratory as well as urinary tract infections.
I wish your test results come negative and your clinical conditions improve soon.
Wishing you good health!
Kind regards,
Dr. Iliri
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Hello
Thank you very much for all of your help. I'm still waiting for my Coronavirus test results to come back that I took on Saturday. My chest, back, and underarms are still very tight and I am still wheezing a little. Lots of things are going through my mind right now. A cardiac ultrasound and treadmill stress test have been ordered for next month. My basic tests such as ekg, troponin, chest xray, and ct scan and basic blood work were negative. I know we're all stressed out now, and I just want to feel better. I started the amoxicillin yesterday but I kinda think I needed something stronger. This chest pressure is all too familiar- and it is stressful waiting on test results. I know chest tightness and pressure is associated with Covid 19 but that's basically the only symptom I'm having combined with a little mild wheezing. All kinds of things are running through my mind: Covid, Asthma or Cardiac Asthma? I know the treatment for cardiac asthma is different from regular asthma, although I have had some doctors to ask me if I had asthma. I've always had normal heart tests in the past and the tests that have already been done don't necessarily point in that direction. But this mild wheezing. I've had a little wheezing in my life but it's a little more obvious to me now. I'm praying that all my tests will continue to be normal. Does Covid 19 show on a CT scan if there was something going with the lungs?
Thank you very much for all of your help. I'm still waiting for my Coronavirus test results to come back that I took on Saturday. My chest, back, and underarms are still very tight and I am still wheezing a little. Lots of things are going through my mind right now. A cardiac ultrasound and treadmill stress test have been ordered for next month. My basic tests such as ekg, troponin, chest xray, and ct scan and basic blood work were negative. I know we're all stressed out now, and I just want to feel better. I started the amoxicillin yesterday but I kinda think I needed something stronger. This chest pressure is all too familiar- and it is stressful waiting on test results. I know chest tightness and pressure is associated with Covid 19 but that's basically the only symptom I'm having combined with a little mild wheezing. All kinds of things are running through my mind: Covid, Asthma or Cardiac Asthma? I know the treatment for cardiac asthma is different from regular asthma, although I have had some doctors to ask me if I had asthma. I've always had normal heart tests in the past and the tests that have already been done don't necessarily point in that direction. But this mild wheezing. I've had a little wheezing in my life but it's a little more obvious to me now. I'm praying that all my tests will continue to be normal. Does Covid 19 show on a CT scan if there was something going with the lungs?
But I want to add: all of my problems started a few weeks ago with frequent urination and lower back pain, and I was not given an antibiotic because nothing showed up in the urine. But I want to say that once I had a uti and the urinalysis was negative but I continued to feel sicker so I went back five days later and I did, in fact, have a urinary tract infection. I think I should have been treated prophylactically because I am prone to having utis. This happened once with the tightnessin my chest and it was because I was infected. The dentist gave me amoxicillin and later pulled my teeth, and I was given Cipro for uti and I got better. And I have some concerns about sepsis. My heart rate and blood pressure have been okay for the most part but I just don't feel right. Still taking the amoxicillin, though. My respiratory rate has been normal most of the time I take it and my oxygen was fluctuating between 98 and 100 percent.when I was at the hospital. I don't sound septic, do I? My temp fluctuates but has basically been within normal ranges.
Brief Answer:
Opinion as follows:
Detailed Answer:
Hello again!
I understand your concern but let me explain that regarding a pulmonary implication of Covid 19, pulmonary CT appears as a high sensitivity test.
As your CT scan has resulted normal, there is nothing to worry about!
An acute cardiac disorder would be reflected on blood oxygen saturation (which in fact is normal) and also on your pulmonary CT scan. Cardiac ultrasound would help to clarify any subtle chronic issue.
Even sepsis would have markedly altered your lab tests (basic blood work), body temperature and heart rate.
May be a genitourinary disorder should be further investigated (including also an ultrasound test).
Considering the fact you experienced breathing difficulties in the past, pulmonary function tests (PFT) would be recommended.
Coming to this point, on my opinion the best thing to do is continuing the actual antibiotic therapy, and waiting for the cardiac tests.
Meanwhile try to relax and avoid negative thoughts as much as possible!
I remain at your disposal for further discussions.
Best regards,
Dr. Iliri
Opinion as follows:
Detailed Answer:
Hello again!
I understand your concern but let me explain that regarding a pulmonary implication of Covid 19, pulmonary CT appears as a high sensitivity test.
As your CT scan has resulted normal, there is nothing to worry about!
An acute cardiac disorder would be reflected on blood oxygen saturation (which in fact is normal) and also on your pulmonary CT scan. Cardiac ultrasound would help to clarify any subtle chronic issue.
Even sepsis would have markedly altered your lab tests (basic blood work), body temperature and heart rate.
May be a genitourinary disorder should be further investigated (including also an ultrasound test).
Considering the fact you experienced breathing difficulties in the past, pulmonary function tests (PFT) would be recommended.
Coming to this point, on my opinion the best thing to do is continuing the actual antibiotic therapy, and waiting for the cardiac tests.
Meanwhile try to relax and avoid negative thoughts as much as possible!
I remain at your disposal for further discussions.
Best regards,
Dr. Iliri
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
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