Brief Answer: He needs hospitalization, urgent tests+treatment Detailed Answer: Hi Mrs. XXXXXXX Thanks for your query. I fully understand your concerns for your husband. Summarizing your husband's case : he is a chronic smoker and drinker, known hypertensive and asthmatic, now having persistent cough with breathlessness on minimal exertion and not responding to anti-asthmatic drugs. These symptoms are suggestive of the following possibilities:- 1. Chronic Obstructive Pulmonary Disease (COPD) with possible Right heart failure (condition is called Cor Pulmonale). It is possible that symptoms have aggravated following a viral/bacterial chest infection. The problem has been compounded by reduced immunity of the body due to chronic heavy alcohol intake. See his tongue and fingers/nails if they have turned blue, which denotes respiratory distress and an emergency. 2. Onset of coronary artery disease, in the background of chronic smoking, hypertension, high cholesterol, chronic heavy alcohol consumption and underlying lung functions' compromise. He needs an urgent tests including, Chest X-ray (for evidence of infection and lungs' status), an ECG + 2-D Echo (for evidence of right-sided heart compromise), Pulmonary Function Test, blood gas analysis and, Sputum examination for evidence of any infection. Ambulatory treatment at home is NOT likely to improve his condition. Hence, the problems should NOT be taken lightly. I strongly recommend that he be persuaded and convinced to get hospitalized at the earliest, as he requires a course of aggressive antibiotics, Ventilin + Seretide in nebulized form to open up the air-passages and, continuous oxygen inhalation under pressure since his oxygen level in the blood is low. Let the Pulmonologist and Cardiologist examine him thoroughly, carry out the advised tests in order to determine the severity of the disease and institute urgent appropriate treatment as required. Hope I have addressed to your concerns to your complete satisfaction and you find my response helpful and informative. I will be happy to answer further queries, if any. Fond regards and have a nice day, Col (Dr.) Rakesh Karanwal

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Brief Answer: Please do so at the earliest. Detailed Answer: Well Mrs. XXXXXXX I shall be looking forward to the test reports. Wishing your husband a speedy recovery.

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