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Lower chest discomfort
Dear Doctor,
I would like to seek your advice regarding my 80-year-old father.
In 2025, he was admitted to the same hospital with heavy breathing and discomfort in his lower chest and upper abdomen. He was diagnosed with acute gastritis, and we were told that his breathing difficulty could be related to the gastric problem.
In 2026, he was admitted again with almost identical symptoms, including heavy breathing and chest discomfort, but without pain or cramps in his chest, jaw or arm. This time, he was diagnosed with acute left ventricular failure (LVF).
We are confused as to why similar symptoms led to different diagnoses on these two occasions. He continues to experience these episodes, particularly after lunch and his afternoon sleep.
Could you please advise whether these recurring symptoms could be related to gastritis or acid reflux, or a cardiac condition ?
Answers (1)
Consult a cardiologist for clinical assessment, ECG, echocardiography and review of previous hospital records.
Assess for coronary artery disease, arrhythmias and other causes of recurrent LV failure; check renal function, electrolytes and BNP/NT-proBNP as needed.
If breathlessness or chest discomfort is occurring currently, or is severe/worsening, seek emergency evaluation to exclude acute heart failure or acute coronary syndrome
Next Steps
Avoid large meals; prefer small, frequent meals and remain upright for 2–3 hours after eating.
Take prescribed heart failure medications regularly; do not self-adjust diuretics or other cardiac medications.
Monitor weight, ankle swelling, breathlessness and ability to lie flat.salt restriction and water intake to be kept less than 1.5 L per day.
Do not assume that symptoms are due to acidity alone. Older adults may have atypical presentations of myocardial ischemia, even without chest pain radiating to the jaw or arm.
Health Tips
May i know how much was his ejection fraction in his echo and any valve issues associated too ?
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