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Persistent Shortness of Breath and Right
Had pneumonia 3 months ago with severe cough and yellow sputum for 20-25 days, followed by sudden right-sided chest pain. While deep-breath, walking, and heavy-lifting pain has mostly subsided, shortness of breath started 2-2.5 months later. Chest X-ray showed normal lungs but indicated a possible 7th rib fracture (?) on the right side. Spirometry (PFT) was normal, though SpO2 was 94%. Current treatment includes 10 days of antihistamines and Foracort 200 Inhaler (twice daily) for 1 month (completed 15 days), but breathlessness persists.
Answers (6)
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As the patient had history of cough 20 to 25 days followed by chest pain on deep breath and followed by sob
Possibilities are pleuritic followed by complicated effusion and pleural thickening leading mild discomfort
We need to know is that spo2 at rest or on exertion
Second possibility rib fracture leading to shallow breath and basal atelectasis
As u said X-ray normal to rule out pe
But for that need to see X-ray film because subtle changes some time missed and as such ct is ideal to do
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Can do d dimer to rule out pulmonary embolism
As the protest probability is low and if at all present it may turn life threatening
First plain ct if no cause rules in on table can decide to go for contrast
2d echo if pe suspected
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Dr. Mangala Kalidas E
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Interventional Pulmonology and Respiratory Emergency Specialist
8 yrs exp
Coimbatore
Next step is to R/o pulmonary embolism.... Need D dimer ,echo and CT pulmonary angiography
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pneumonia does take time to resolve..but if the saturation is hovering around 94 then do connect with all your docs
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It will be more helpful to interpret and suggest you the best care, if you can share all the imaging done and blood tests done.
Also let me know if you have any swelling of feet, palpitations
Also let me know if there is any history of smoking, alcohol intake, tobacco usage & what is your occupation.
Did you get admitted during your illness with cough ? If so what’s the treatment recieved?
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Dr. A Raja Prasanna Kumar
Pulmonologist
47 yrs exp
Hyderabad
Pl consult pulmonologist.
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Dr. Kirubanandam Arularasan
Respiratory Medicine
12 yrs exp
Thanjavur
Your were treated for pneumonia and having symptoms with normal lunch fields with spo2 of 94 % needs further evaluation. We need to rule out pulmonary embolism and reason for hypoxia.
Next Steps
D dimer
echo
CT pulmonary angiography to rule out pulmonary embolism
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Disclaimer : The content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding your medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read on this website.