Thank you for your query at DoctorSpring.com
May I also know your, smoking and occupational history and treatment history. Other than sinus problems and bronchitis, do you have any other significant medical problem? Did it have any radiation to neck, and did you notice any alleviating factors? Can you also describe the pain? Have you taken any hormonal treatment?
I gather that you did not benefit from albuterol.
The likely cause of pain I gather should me muscular in origin. X ray was normal. EKG also normal. You do mentioned that saturation fell to 94% however can I know the base line?
Other than musculo-skeletal pain, the only possible cause would be a pulmonary embolism that produces desat, chest pain and increased heart rate.
I too suggest a CT scan of chest to rule out any minute causes of chest pain and breathlessness.
Kindly reply so that we may help you better.
Dr. Jacob George P
MD IDCCM FCCP
Patient replied :
I was exposed to a great deal of second hand smoke as a child and as such I was in and out of the hospital and doctor's office often. I was diagnosed with chronic bronchitis as a child and was given a nebulizer for the home as well as albuterol. I started smoking at age 11 and then at age 15 I started smoking kreteks (clove cigarettes) and other strong cigarettes. I quit smoking five years old patientago.
The pain does have a slight radiation to neck at times and can not be alleviated. I have even tried Advil. The pain dull and seems to be worse when I am having trouble breathing. It comes and goes. No hormonal treatment.
I also have endometriosis and aednomiosis.
Albuterol does help. But I started having shortness of breath with activity, which was a new development.
X ray was not normal. It showed peribronchial cuffing.
Oxygen saturation baseline 98.
I also noticed last night that my heart rate goes from 70s sitting to over 100 upon standing.
There is a possibility of pulmonary embolism from the description you give. However I still feel its vague, and cannot be that. I feel it is mostly musculo skeletal in origin. As for breathlessness, it should be the same asthmatic attack. Albuterol can cause muscle spasm and cramps. Anyway I suggest a CT to rule out pulmonary embolism. (Your x rays are suggestive of chronic bronchitis only and does not account for your symptoms)
Please feel free to discuss further,
Dr. Jacob George P
MD FCCP IDCCM