Are lower SpO2 and fast heart rate asthma symptoms?

@ling. I have eosinophilic asthma and lots of allergies. I tend to get sinusitis and that can create an infection that moves down into my lungs creating phlegm. When my resting heart rate goes up, that is my cue that I have a chest infection and I have soreness in my throat from the post nasal drip. I found a simple way to manage this.

From a prior surgery, I was instructed to use a topical antibiotic ointment Mupirocin in my nose to prevent a staff infection before the procedure. I tried this when I got a sinus infection and it worked. I do this when I go to bed so it doesn’t just run out of my nose. After clearing out my nose, I put a glob the size of a small pea in each nostril. I can get everything cleared in 2 to 3 days and I treat one day past when the symptoms are gone. This causes a die off of bacteria, so expect to need to clear phlegm the next day.

My heart rate goes up because there is too much phlegm obstructing oxygen absorption caused by an infection. Any physical problem with expansion of the chest wall can create a situation where not all phlegm is expelled because the lungs are not moving enough. I have a condition Thoracic Outlet Syndrome that causes tightness on one side of my chest, and that is the side where a chest infection will start.

I usually notice my heart rate being too high after walking up a flight of stairs when an infection starts. My doctors let me keep the antibiotic ointment on hand so I can treat the sinus/chest infection as needed.

I also take antihistamines and use inhalers as needed and run HEPA filters inside my home. I also have done allergy shots and should be doing them, but I don’t like to poke myself with a needle. I should be better about that.

Jennifer

Hi Jennifer,
Thank you so much for sharing your experience with me. Do you remember how you were diagnosed with eosinophilic asthma? Do you have to take medication to keep the level at normal range? When your rest heart rate goes up, do you know if the eosinophil level is high? I alway wonder about that.

Thanks again.

Ling

@wangling I was diagnosed at Mayo. The only Rx I was given was a Qvar inhaler. I do treat my allergies and use air filters and I do OK. I was started on the lowest dose of Qvar and told I could take a double dose of if I need it. If the mold count is high outside, that’s when I have more trouble. I don’t know any of the numbers from my bloodwork. Most of the time I do OK. When my heart rate is up it is because of phlegm. If it is an infection, clearing the phlegm doesn’t help the heart rate. Otherwise just using the rescue inhaler Xopenex doesn’t raise my heart rate very much, unless it is in a nebulizer that is more effective at getting it deep into the lungs.

Jennifer

Hi Liz. Who prescribed you doxy and prednisone- a pulmonologist or a cardiologist. I have high heart rate and lower than normal oxygen level plus fast heart beating- like pounding. my pulmo changed my inhaler twice because I thought it was the reason. Nothing changed though and the fast heart beat is even more often. So I was advised to see a cardiologist ( see him next week). And honestly I am anxious to look for another problem but I do not feel well.

I had just seen the cardiologist and had an echo cardiogram and my heart function was normal (I had myocarditis and temporary heart failure a year ago but recovered and am being monitored) and I am on a beta blocker (a certain kind that allegedly does not make asthma worse) for high blood pressure. My asthma/possible infection was getting worse (sob more mucus) so I took the doxy which I have on hand for this (given by the pulmo) and the prednisone (from the allergist and the pulmo). Whenever I am ill even on a beta blocker my HR rises about 15 points above what it is normally and I can tell. (90s instead of mid 70s during the day) That is very consistent. As the pills work in a few days my HR goes slowly down and back to normal where it is right now. I finished the doxy today and lowered the pred to 20 mg for a few days then will drop it again. Fingers crossed! I am not 100% back to normal - I'm tired - but my HR is and that bodes well. Maybe you need some blood work to show infection? Since the days of fitbit and other heart rate monitors it is becoming more and more known that illness will raise your heart rate significantly. As the cardio about that if you have a chance. The heart pumps more to move around the fighter cells or whatever to take on the infection or something like that!

Go with what pulmonologist says. I have that type of asthma too.

Sounds like asthma.

Scoop, I am curious about your comment that you wonder if diagnosis of “asthma is correct. There is no definitive test for it I think”

I was diagnosed with mild asthma by the first pulmonologist I saw after my abnormal CT with nodules and trees-in-bud, but before bronchiectasis developed. He did a methacholine challenge and mine showed 20%decrease in FEV1 and a rapid response to bronchodilators and he said it was diagnostic for asthma. I’d also had a PFT at an immunologist office a few years before and one at work. My immunology appointment was for an autoimmune condition, but I was having the horrid coughing episodes and she was convinced I had asthma. She did a PFT in office immediately and I passed (though barely). I’d also had a previous one at work that was normal. I told the doc who did the methacholine challenge about the two previous normal ones and he said I hadn’t had the right test and suspected I’d had asthma for a while. Because of his comment and Mayo’s agreement with diagnosis, I thought the challenge was a pretty definitive test, but haven’t done research. Have you had one? Are they typically ordered?

@pacathy Not 100% sure you are replying/asking me. [machine generation says someone different...]

Anyway, no methacholine challenge ever. Pulmonary said I needed to be off of steroids to avoid false negatives before taking test. I got the impression this was not a regularly administered test but your place might be more thorough. In the age of managed care perhaps it is a less often administered diagnostic test. I will ask the spirometry person next time I am in.

I take symbicort daily and they are convinced I have asthma. PFT show mild restrictive with FEV1 in normal range (except with bronchiectasis exacerbation.)

Pulmonary doc spelled it out for me when I asked "how do you know it's asthma" ?
1) Symptoms: cough, wheeze, SOB, tightness (esp, tightness)
2) Triggers: GERD, pets, allergies
3) Asthma gets better with asthma medication (albuterol, symbicort, etc)

My symptoms definitely get better with albuterol. For now, I am on inhaled steroids at the lowest effective dose.

Scoop, you’re correct. I was replying to you. The first pulmonologist made the methacholine challenge sound like the definitive test and that had been my impression. It makes sense that steroids would impact results (and I like things to make sense). Thanks for replying.