No diagnosis for pain/shortness of breath in chest

Hello,

My husband, who lives in Jamaica recently had a reoccurring episode of shortness of breath/pain in his chest, accompanied/followed by a cough while laying down before bed. He had a previous episode about 9 months to a year ago while on his way to work with similar symptoms; the shortness of breath feeling more like an inability to breathe at all. Most times (every year or so), he says, they just give him oxygen until he can breathe normally again and send him on his way. He went to the doctor for a check up about 2 months ago and his primary physician told him he had high blood pressure. He had been smoking for a few years and quick when he was told. At the hospital after this most recent episode the doctors took an X-ray of his heart and told him they saw nothing abnormal there. He was still experiencing pain in his chest and he told me they prescribed him something for the pain called "Buerosen"? I was confused about why they would prescribe such a seemingly strong medication without getting to the origin of the issue and without any procedures being done. I'm heading down to the island and want to know if there are any ideas about what the issue could be so that we can find a specialist who can address the actual cause and not put band-aids on the symptoms?

[David Tinkelman, M.D.]

Your husband’s symptoms, sudden onset of shortness of breath accompanied by chest pain, could be a sign of heart disease, lung disease, heartburn or a type of anxiety attack, called a panic attach. A normal Chest X-ray is reassuring but does not exclude the possibility of any of the preceding.  The quality and location of his pain might provide his doctors a clue as to the cause of it, so he should be prepared to carefully describe the quality of his pain and, if he can, what exactly he feels when he experiences “an inability to breathe.”

If heart disease, the problem could be either coronary artery disease and/or an abnormal heart rhythm.  If lung disease consideration would have to be given to blood clots to the lungs.  What is commonly called GERD (gastro-esophageal reflux disease) can closely mimic the symptoms of heart disease, is not always associated with classic heartburn.  If suspected, tests that explore stomach and esophageal function would be required.

As for a specialist, I would recommend that your husband first see a heart specialist (cardiologist) or a lung specialist (pulmonologist) either of which would be capable of sorting out the possible causes noted above.

Good luck