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Suggest Treatment For Severe Headaches And Chest Pain

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Posted on Tue, 26 Aug 2014
Question: Been very tired lately and having severe headaches. Went to the local ER. The refused to do a blood gas but in the general labs, the co2 was 43. My usual is around 36 or so. Do you know how bad this is? Is there a way to do a conversion to get the number they would get in an arterial blood gas? I hear there is a formula to get that number.... I can not tolerate Bipap. It gives me severe chest pain and hurts my respiratory muscles. So I can not blow off co2 mechanically. Is there any other way? I am afraid I will crash and go into failure if I do not get these numbers down.
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Answered by Dr. Dr. Muhammad Sareer Khalil (2 hours later)
Brief Answer:
Queries explained..

Detailed Answer:
Hello and welcome.

I have read your history carefully.

Please try to calm yourself down and relax as panic and anxiety can exacerbate your condition.

The normal PCO2 is usually between 35 to 45. Value near 40 is taken to be normal. The interpretation can not be done alone on PCO2 as the pH is required in addition to other parameters to determine acidosis or alkalosis.

PCO2 alone cant be used to calculate any formula number that you are suggesting.

Bipap (Bi level positive airway pressure) can be used in cases of difficulty in breathing like pneumonia, chronic obstructive pulmonary disease, asthma and others. If you are uncomfortable with bipap the salbutamol or formetrol nebulization can be done to relieve your symptoms.

I would advise the following in consultation with your doctor.

Ibuprofen 400 mg tds for the headache
Blood pressure monitoring to see for significant spike in association with the headache
A baseline EKG to rule out any cardiac cause for the shortness of breath

let me know if you have any query
I will be more than glad to answer.

thanks




Above answer was peer-reviewed by : Dr. Ashwin Bhandari
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Answered by
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Dr. Dr. Muhammad Sareer Khalil

General & Family Physician

Practicing since :2012

Answered : 2906 Questions

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Suggest Treatment For Severe Headaches And Chest Pain

Brief Answer: Queries explained.. Detailed Answer: Hello and welcome. I have read your history carefully. Please try to calm yourself down and relax as panic and anxiety can exacerbate your condition. The normal PCO2 is usually between 35 to 45. Value near 40 is taken to be normal. The interpretation can not be done alone on PCO2 as the pH is required in addition to other parameters to determine acidosis or alkalosis. PCO2 alone cant be used to calculate any formula number that you are suggesting. Bipap (Bi level positive airway pressure) can be used in cases of difficulty in breathing like pneumonia, chronic obstructive pulmonary disease, asthma and others. If you are uncomfortable with bipap the salbutamol or formetrol nebulization can be done to relieve your symptoms. I would advise the following in consultation with your doctor. Ibuprofen 400 mg tds for the headache Blood pressure monitoring to see for significant spike in association with the headache A baseline EKG to rule out any cardiac cause for the shortness of breath let me know if you have any query I will be more than glad to answer. thanks