Recurring Difficulty to Breathe

Patient

Q: I will try keep this short, Im a 23 year old male and fairly active, For the past month i have been having difficult breathing, Its not too the point where im going to drop dead, But i haven't seen an improvement in almost a month now, To describe it would be like my body isnt getting in that last big breathe it needs to the point that im almost gasping to get it in ( every minute or so ), The right side of my chest gets sore too but i think thats more muscle strain from gasping.

I had a chest infection recently and all this showed up after it passed, I have had asthma growing up but never has it been bad or hindered my breathing, I could actively play sports without even needing inhailers. ( I have started taking my inhailers again just incase and seen absolutely no improvement )

I do suffer from HCM ( hypertrophic cardiomyology ) And majoirty of the time the GP just answers everytime " See your cardioligist" 9/10 he wont even do basic checks and just tells me to see my cardiologist. ( This has always been a similar story of my life GP like to throw me in the too hard to do basket) Which again is frustrating, i see my cardiologist every 6 monthly my heart is fine, I have had no issues in the past 8+ years with my heart, And have shown no signs that my heart could be causing this breathing issue,

I have been to my local GP Twice now. I have had chest xrays done and they have listened to my lungs, But thats as far as it always gets, they just tell me i sound healthy and nothings on the xray to show anything out of place.

Its starting to get frustrating now as i know something isnt right Do you have any advice or something i could suggest to my GP?

Symptoms:  Difficult breathing/ Pain on right side of chest ( feels more like muscle strain from gasping )/ Gasping/ Asthma
Doctor

A:   Thank you for your question.

I note the longstanding difficulty in breathing and recent chest xray results.

It would be difficult to suggest nothing is wrong when the symptoms are still present. Further investigations are needed and should be approached in a step wise fashion.

Firstly, a different set of inhalers should be used to see if your asthma responds better to a newer medication. While you are trialing new inhalers, a cardiac echo and pulmonary function test should be done.

The pulmonary function test will assess the severity of your asthma (if any) and the cardiac echo will rule out the possibility of heart disease or heart failure causing your symptoms. Hypertrophic cardiomyopathy you have indicated would be unlikely to be the sole cause of your symptoms.

In addition, the possibility of atenolol causing shortness of breath is possible and you should speak to your cardiologist if a trial of another medication is warranted.

Lastly, non cardiac and non respiratory causes such as an environmental allergy should be explored. This would be more likely the case if your symptoms were only present in specific setting or certain times of days.

Please update us on the status of your tests.

Thank you


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