[39M] Experiencing severe shortness of breath and fatigue

Patient Description

A 39-year-old male presents with extreme fatigue, severe shortness of breath (rated 8-9/10), feeling cold, significant hair loss, and episodes of dizziness with a sensation of being close to passing out, persisting for about a month. These symptoms occur regardless of activity level and are not alleviated by changes in position. The patient has a history of coronary artery disease diagnosed in 2023 and Achalasia diagnosed in 2019. The patient's medication regimen includes Repatha injections every two weeks, daily doses of Lisinopril 40mg, Rosuvastatin 50mg, Zetia 10mg, Metoprolol 25mg, and Aspirin 81mg. There is a family history of cardiac and thyroid diseases, but no known drug allergies or recent substance use.

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Arora's Assessment

What might be happening

Based on the symptoms you've described, possible diagnoses include:

  • Anemia: This condition occurs when your body doesn't have enough red blood cells or hemoglobin. Hemoglobin is a main part of red blood cells and binds oxygen. If you have too few or abnormal red blood cells, or your hemoglobin is abnormal or low, the cells in your body will not get enough oxygen. Symptoms of anemia — like fatigue, shortness of breath, and cold hands or feet — occur because organs aren't getting what they need to function properly.

    • Treatment for anemia usually involves taking iron supplements and making changes to your diet. If the anemia is due to a chronic disease, the disease will need to be treated and controlled.
  • Thyroid Disease: Given your family history and symptoms of fatigue, cold intolerance, and hair loss, a thyroid disorder such as hypothyroidism could be a possibility. Hypothyroidism is a condition in which the thyroid gland does not produce enough thyroid hormones. Thyroid hormones regulate the body's metabolic rate as well as heart and digestive function, muscle control, brain development, mood, and bone maintenance.

    • Treatment for hypothyroidism typically involves daily use of the synthetic thyroid hormone levothyroxine.
  • Heart Failure: Given your history of coronary artery disease and symptoms of extreme fatigue and shortness of breath, heart failure could be a possibility. Heart failure, sometimes known as congestive heart failure, occurs when your heart muscle doesn't pump blood as well as it should. Certain conditions, like narrowed arteries in your heart (coronary artery disease) or high blood pressure, gradually leave your heart too weak or stiff to fill and pump efficiently.

    • Treatment for heart failure usually involves a combination of medications, and sometimes surgery.

Please note that these are only possibilities and not definitive diagnoses. It's important to see a healthcare provider for a proper evaluation and diagnosis.

What you can do

Given the severity of your symptoms, it's important to seek medical attention as soon as possible. In the meantime, try to rest and stay hydrated. Avoid exerting yourself physically, as this could worsen your symptoms.

What you should look out for

If you experience any of the following symptoms, seek immediate medical attention:

  • Chest pain or discomfort that doesn't go away after a few minutes
  • Pain or discomfort in the jaw, neck, or back
  • Weakness, light-headedness, nausea, or a cold sweat
  • Pain or discomfort in the arms or shoulder
  • Shortness of breath or difficulty breathing

Remember, I'm an AI and this advice is based on the information you've provided. It's always important to consult with a healthcare provider for an accurate diagnosis and treatment.

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10 mo ago

People Also Ask


What are the common symptoms of anemia and how is it treated?

Common symptoms of anemia include fatigue, shortness of breath, dizziness, cold hands or feet, and hair loss. Treatment often involves iron supplements and dietary changes, but if anemia is due to a chronic disease, that condition must be treated as well.


How can thyroid disease affect my overall health and what are the treatment options?

Thyroid disease, such as hypothyroidism, can lead to symptoms like fatigue, cold intolerance, and hair loss. It affects metabolic rate, heart and digestive function, and more. Treatment typically involves taking synthetic thyroid hormone levothyroxine daily.


What are the signs of heart failure and how is it managed?

Signs of heart failure include extreme fatigue, shortness of breath, and swelling in the legs. Management usually involves medications to help the heart work more efficiently and sometimes surgery, depending on the severity.


How does a family history of cardiac and thyroid diseases impact my health?

A family history of cardiac and thyroid diseases can increase your risk of developing these conditions. It's important to monitor your health closely and discuss your family history with your healthcare provider for appropriate screening and preventive measures.


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