[46M] Experiencing shortness of breath and difficulty sleeping

Patient Description

A 46-year-old male presents with shortness of breath rated 8/10 in severity, occurring when walking upstairs or short distances for a few weeks. The symptom improves with rest. The patient also reports a mild, wet cough with phlegm lasting a few months, but not constant. Difficulty sleeping flat due to breathing issues has led to sleeping upright, waking up at night short of breath, and occasional low energy and focus during the day. The patient has a past smoking history, a family history of lung disease, and a personal medical history of hepatitis C diagnosed in 2000. Currently, the patient is taking Tadalafil 2-3 times a month at a dosage of 10mg and reports no allergies to medications.

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Arora's Assessment

What might be happening

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

  • Heart Failure: This condition occurs when your heart can't pump enough blood to meet your body's needs. Symptoms can include shortness of breath, coughing, and difficulty sleeping flat due to breathing problems. Given your age and history of smoking, this could be a possibility.

    • Treatment typically involves medications to manage symptoms and prevent the progression of the disease, lifestyle changes like a low-sodium diet and regular exercise, and sometimes surgery or medical procedures.
  • Chronic Obstructive Pulmonary Disease (COPD): This is a chronic inflammatory lung disease that causes obstructed airflow from the lungs. It's most commonly caused by long-term exposure to irritating gases or particulate matter, most often from cigarette smoke. People with COPD are at increased risk of developing heart disease and lung cancer.

    • Treatment can alleviate symptoms, reduce the risk of complications, and generally improve quality of life. Medications, supplemental oxygen therapy, and surgery or lung procedures may be used.
  • Pulmonary Edema: This condition occurs when fluid collects in the air sacs of your lungs, making it difficult to breathe. It can be caused by heart conditions, pneumonia, exposure to certain toxins and medications, and exercising or living at high elevations.

    • Treatment typically involves medications to help your body get rid of the excess fluid and to improve the function of your heart.

Please note that these are possibilities based on the symptoms you've described, and not a definitive diagnosis. It's important to consult with a healthcare provider for an accurate diagnosis.

What you can do

  1. Schedule an appointment with your healthcare provider as soon as possible. They can perform tests to confirm a diagnosis and determine the best course of treatment.
  2. Monitor your symptoms and note any changes or patterns. This can be helpful information for your healthcare provider.
  3. Try to maintain a healthy lifestyle. This includes eating a balanced diet, getting regular exercise, avoiding smoking and secondhand smoke, and limiting your alcohol intake.

What you should look out for

Seek immediate medical attention if:

  • Your shortness of breath becomes severe or you experience chest pain.
  • You have difficulty breathing even when at rest.
  • You feel like you're not getting enough air.
  • You're feeling faint, dizzy, or have a loss of consciousness.

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

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9 mo ago


People Also Ask


What are the common symptoms of heart failure?

Common symptoms of heart failure include shortness of breath, fatigue, swollen legs, and rapid heartbeat. Difficulty sleeping flat due to breathing issues is also a common symptom.


How does smoking history affect the risk of developing COPD?

Smoking is the leading cause of COPD, as it damages the airways and air sacs in the lungs. A history of smoking significantly increases the risk of developing COPD and can exacerbate symptoms.


What lifestyle changes can help manage symptoms of pulmonary edema?

Lifestyle changes to manage pulmonary edema include reducing salt intake, maintaining a healthy weight, avoiding alcohol, and following a heart-healthy diet. Regular exercise and quitting smoking are also beneficial.


When should someone with breathing difficulties seek immediate medical attention?

Immediate medical attention should be sought if shortness of breath becomes severe, if there is chest pain, difficulty breathing at rest, a feeling of not getting enough air, or if there is fainting, dizziness, or loss of consciousness.

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