Question: I have been having bad bouts of shortness of breath. My primary care physician has put me on oxygen, which has helped a lot, especially at night. However, I would prefer not to use it. I take Coumadin and several medications for a heart condition. (I’ve had two triple-bypass surgeries and an open-heart procedure for a leaky valve.) But the shortness of breath is really bothersome.

Dr. Hibberd’s Answer:

Your shortness of breath is concerning. Your doctor clearly has found a temporary fix, but you will need further intervention, whether this is caused from a heart, lung, or other condition.

It appears you have an artificial valve replacement, and your Coumadin blood thinner is given to reduce clot formation. Is your valve functioning correctly? Has your old diseased valve that was replaced caused permanent damage to your lung tissue that is now more apparent with your valve replacement? Is any of this shortness of breath related to further coronary artery disease that needs to be addressed? Is there any sign of heart or lung failure? Can this be explained by any other disorders such as undiagnosed infection, inflammation, smoking damage, hypothyroidism, anemia, dehydration, or medication side effect?

It is time for you to know more about why this is occurring. See your doctor and have someone go with you to be sure all your questions are answered. You might ask if a pulmonary and cardiology consultation is advisable, and be sure to inquire whether these problems are correctable with medication (inhaled, oral, or injectable), as you have some further options aside from simple oxygen supplementation alone.

Above all, be sure you understand why you are short of breath, and once this is clear, the remedies offered will begin to make sense. This may take a little time and education, so be sure to go to your appointment with a written list of questions, and bring a family member or a friend.