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History of pneumonia and breathless now

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I am 23 years old female. Last October I had double pneumonia with pleural effusion and was in HDU. I have also since been diagnosed with atrial flutter with 2:1 heart block and had an appendicectomy mid December. I was admitted to A&E a couple of days ago having a flutter with HR 160bpm and shortness of breath. The chest x-ray revealed shadowing at base of lungs and I had reduced air entry in base of my lungs. I have since got more breathless and my chest feels very tight. Should I be worried... could this be a relapse of the pneumonia? I haven't had any temperatures (although I never did with my previous pneumonia) but am feeling very lethargic and shivery.

Category: Pulmonologist

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Category: Allergy and Immunologist
Dr. Jacob George Pulinilkunnathil is online now

Expert:  Dr. Jacob George Pulinilkunnathil replied 4 Days.

Dear patient,

Thank you for your consult at DoctorSpring.com.

Please answer me with the following to help you best.
Please let me know what you meant by double pneumonia?
Would you be able to provide the previous x ray and present x ray for comparison and assessment?
Are you losing weight inspite of having good appetite?
How is your thyoid status?

Reduced air entry on both sides does not suggest pneumonia, and might hint it secondary to a cardiac cause- because of the heart rate of 160. Your medical history doesn't seem comfortable for me - for an age of 23.
Do you have renal stones ?
Chest tightness and breathlessness can be due to asthma exacerbation, and the medicines you take for asthma- if taken in high doses, or wrong doses can cause AF. So i would like to know your asthma medications/ any medications going on.

Presently, all I can say is that this symptomatology doesn't fit into that of pneumonia. I feel its more of a high heart rate that is causing the discomfort. Instead of pressing the panic button, I would like to review the medicines going on, rule out an asthma exacerbation, looking out for other treatable medical causes of AF.

Hope this helped. Feel free to use up the review questions for more clarifications.

Wishing you a speedy recovery
Dr. Jacob George P

Dr. Jacob George Pulinilkunnathil
Category: Allergy and Immunologist
Residency, Post Graduation: MD, Respiratory Medicine, J L N Medical College, Ajmer, Rajasthan (2012).
Medical School, Internship: MBBS, Government Medical College, Kottayam, 2001-07 
Indian Diploma in Critical Care Medicine (IDCCM) - Medical Trust Hospital, 2013-2014.
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