Brief Answer:
I would recommend as follows:

Detailed Answer:
Hello!

Welcome and thank you for asking on HCM!

Regarding your concern, I would explain that your symptoms could be related to different possible causes:

- exacerbation of asthma
- uncontrolled high blood pressure
- a possible cardiac arrhythmia
- possible coronary artery disease, although you chest pain would be more typical of this disorder.

I would like to directly review your resting ECG and other performed tests, if you can upload them for a more professional opinion.

I would also recommend performing further tests:

- a chest Xray study and respiratory function tests
- a cardiac ultrasound to examine your cardiac function and structure and pressure values in the pulmonary artery
- an ambulatory 24-48 hours ECG monitoring would be needed to investigate for possible cardiac arrhythmia
- some blood lab tests ( cardiac enzymes, complete blood count for anemia, liver and kidney function tests, blood electrolytes, fasting glucose).

I would be happy to review all your tests, if you can upload them.

I remain at your disposal for any further questions.

Kind regards,

Dr.Iliri

---

Brief Answer:
My opinion as follows:

Detailed Answer:
Dear XXXXXXX

I carefully reviewed you uploaded ECG and would explain that it shows only a right axe deviation which is typical for lung disease.

There are no signs of cardiac ischemia or cardiac arrhythmia.

Coming to this point, a pulmonary embolism can not be excluded either.

The chest X ray study has not shown any specific signs.

For this reason, I would recommend performing a pulmonary angio CT scan to investigate for possible pulmonary thrombo-embolism. A Pulmonary ventilation-perfusion CT scan would be a more sensitive test compared to angio CT scan for to investigate for this disorder.

I would also recommend performing some other tests:

- a cardiac ultrasound to examine your heart function and the pressure in the pulmonary veins
- D-Dimmer levels to investigate for pulmonary embolism
- blood electrolytes
- kidney and liver function tests
- complete blood count for anemia
- fasting glucose.

You should discuss with your doctor on the above issues.

Hope to have been helpful!

Feel free to ask me again whenever you need!

Wishing all the best,

Dr. Iliri

---

Brief Answer:
I would explain as follows:

Detailed Answer:
Hello again!

Thank you for the additional information!

I carefully reviewed your lab test reports and would explain as follows:

- Your white blood cell count is high, with predomination of neutrophils(80%), which is indicative of a bacterial infection. For this reason, I agree with your doctor on the decision of starting an antibiotic (Levofloxacine).

- Your total cholesterol and LDL values are a little high, but your Total cholesterol/HDL ration and LDL/HDL ratio are within the normal ranges, which means that you do not suffer from dyslipidemia and you do not need to be treated for this reason.

- Your thyroid hormone levels and other blood lab tests are perfectly normal.

Coming to this point, I would recommend continue taking Levofloxacine.

If your situation does not improve, I would recommend performing the above mentioned tests (d-Dimmer, pulmonary angio CT scan and a cardiac ultrasound) to exclude possible pulmonary thromboembolism (which can not be excluded by your performed tests).

Hope to have been helpful to you!

If you have any other questions, please do not hesitate to ask me again!

Wishing all the best,

Dr. Iliri

---

Brief Answer:
I would explain as follows:

Detailed Answer:
Hello again!

I agree with your doctor prescription.

Levofloxacine acts against the infection.

Dexamethasone helps against the inflammation and improves the respiratory function (it helps against asthma exacerbation too).

Theophyline helps for the respiration and prevents exacerbation of asthma.

Aspirin helps to prevent stroke or blood clotting.

Atorvastatine lowers your cholesterol levels. Although it is not really necessary considering your blood lipid profile.

Anyway, these drugs are only for a pulmonary infection and asthma exacerbation.

They are not effective against pulmonary thromboembolism.

Fro this reason, if your situation does not improve, I would recommend proceed with the other above recommended tests.

Hope to have been helpful!

Wishing all the best,

Dr. Iliri

---

Brief Answer:
My opinion as follows:

Detailed Answer:
Hello again!

Regarding your concern, I would explain that Aspirin is not contraindicated in asthma patients.

But, sometimes the patients which suffer from asthma are also allergic to aspirin.

This causes an exacerbation of rhinitis or asthma.

But this does not happen in every patient which suffers from asthma.

Have you ever tried taking aspirin?

If you have never tried aspirin, I would recommend trying it. If you do not tolerate it (it triggers your asthma), you should discuss about this with your doctor.

Hope to have clarified some of your uncertainties!

Wishing good health,

Dr. Iliri

---