[34F] Experiencing respiratory and nasal symptoms when lying down

Patient Description

A 34-year-old female has been experiencing significant respiratory distress characterized by shortness of breath and a burning sensation when breathing, which intensifies upon lying down. The symptoms, persisting for a week, are somewhat alleviated when sitting up. Additionally, she reports an unusual sensation of excessive air intake through the nose, accompanied by a burning feeling, making it difficult to breathe properly. These symptoms are rated as severe, with a score of 8 out of 10. The patient has a history of Chiari Malformation diagnosed a year ago and is allergic to penicillin, codeine, morphine, and IV contrast dye. She is not currently on any medications.

Arora's Assessment

What might be happening

Based on the information you've provided, possible diagnoses include:

Gastroesophageal Reflux Disease (GERD): This is a condition where stomach acid frequently flows back into the tube connecting your mouth and stomach (esophagus). This backwash (acid reflux) can irritate the lining of your esophagus, causing a burning sensation. It can also cause shortness of breath, especially when lying down.
- Treatment typically involves lifestyle modifications and over-the-counter medications. If these don't help, your doctor might recommend prescription medications or surgery.
Heart conditions: Conditions such as heart failure or coronary artery disease can cause shortness of breath, especially when lying down, and palpitations. These conditions can be serious and require immediate medical attention.
- Treatment depends on the specific condition and its severity. It can range from lifestyle modifications and medications to surgery.
Anxiety disorders: These are a group of mental health disorders characterized by feelings of anxiety and fear. Symptoms can include shortness of breath, palpitations, and a feeling of being smothered or choked.
- Treatment typically involves psychotherapy (talk therapy), medications, or both.

Please note that these are just possibilities and not a definitive diagnosis. Only a healthcare professional can provide a formal diagnosis.

What you can do

Seek immediate medical attention. The combination of your symptoms, especially the shortness of breath and palpitations, could indicate a serious condition that needs immediate attention.
If you're diagnosed with GERD, lifestyle changes such as avoiding certain foods and not eating before bedtime can help. Over-the-counter medications such as antacids, H2 blockers, and proton pump inhibitors can also help.
If you're diagnosed with a heart condition, follow your doctor's treatment plan closely. This may involve taking medications, making lifestyle changes, and possibly undergoing surgery.
If you're diagnosed with an anxiety disorder, psychotherapy and medications can help. Relaxation techniques such as deep breathing, meditation, and yoga may also be beneficial.

What you should look out for

Seek immediate medical attention if:

Your shortness of breath worsens or you have difficulty breathing even when not lying down.
You experience chest pain or pressure.
You faint or lose consciousness.
Your heart palpitations are accompanied by dizziness, lightheadedness, or fainting.

Remember, I'm an AI and not a doctor. Please seek care from a healthcare professional for a formal diagnosis and treatment.

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8 mo ago

Top picked over-the-counter products for Acid Reflux (GERD): American College of Gastroenterology Guidelines