History Of POTS And Lupus. Felt Breathless. Echo, CBC, Chest X-ray Normal. What Could Be The Cause?

Posted on Sun, 13 Oct 2013

Question: Hi Doctor. I am 27 year old female. I have a history of POTS (Lupus. Last Wed. I was running on the treadmil and i did great! I was proud of myself but the next morning i woke up and i couldn't breathe! it feels like I just can't get enough air in my lungs no matter how hard I try! its been going on for a week now. My pulse OX is 100% on Room air, my chest Xray is negative. CBC, BMP both looked good too. Those are the only tests I had done. My chest doesn't feel tight at all I just don't feel like im getting enough air.
My Blood pressure is running 100/60s and pulse can be anywehere from 60-110 depending on my P.O.T.S . I did a self Flow meter on myself and at 5'3 weighing 135 and age 27 female my flow meter was 440 sometimes 450.

What is wrong? I am so scared I could have Interstitual lung disease or pulmonary htn

I had a regular CT of my chest back in XXXXXXX because the same thing happened ( I just felt i couldn't breath) and it was negative.
I had an ECHO in XXXXXXX as well which was good
and an echo stress test in november- (when i was diagnosed with POTS)
I am SO SO SO scared that I have a lung disease.

Answered by Dr. Srikanth Reddy (2 hours later)

Brief Answer:
Need a ECG

Detailed Answer:
Hello,
Thanks for choosing health care magic for posting your query.
I have gone through your question in detail and I can understand what you are going through.
You have certainly underwent most of the required tests but one test that was important and which you have not stated (which i presume that you have not done) is an Electro Cardio Gram. (ECG). ECG will detect if you have any ectopic beats or any change in the rhythm although your pulse may remain stable. If your X-ray has come normal and the symptoms have persisted for 4 days , it cannot be a serious condition.
Sometimes allergies cause bronchoconstriction and that can lead to this symptom. In my clinic many times I ask my patients to take a salbutamol spray and that resolves the symptoms.
Another possibility is a gastro-esophageal reflux disease as refluxes also cause such a symptom.
Hope I am able to answer your concerns.
If you have any further query, I would be glad to help you.
If not, you may close the discussion and if possible you may rate the answer for me, so that I get a good feedback.
In future if you wish to contact me directly, you can use the below mentioned link:
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Wish you good health,
Kind regards
Dr. Srikanth Reddy M.D.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Srikanth Reddy (2 minutes later)

the symptoms have gone on for a week now with no relief. they even gave me an inhaler. it doesnt seem to help. I have had MANY EKG's all normal - I get EKG's alot due to my POTS , im just on plaquenil and nadolol... I dont understand whats going on

so i dont have to worry about interstitual lung disease? im scared that my lungs are going to fail me

Answered by Dr. Srikanth Reddy (7 minutes later)

Brief Answer:
Anxiety is a possibility

Detailed Answer:
Hello
Thanks for the follow-up.
If your X-ray is normal then it is unlikely to be an interstitial lung disease. Moreover the Interstitial lung disease do not arise in such acute form.
If all the possibilities are rules out, anxiety disorder can lead to this kind of symptom and then clonazepam can help in relieving the symptoms.
Hope that helps
Regards'
Dr. Srikanth Reddy

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Srikanth Reddy (0 minute later)

thank you!

Answered by Dr. Srikanth Reddy (1 minute later)

Brief Answer:
You are most welcome

Detailed Answer:
You are most welcome...

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar