Concerns Surrounding Breathing with Myasthenia Gravis
A 33-year-old female, suspected of having Myasthenia Gravis (MG), began a trial of Mestinon at a dosage of 30mg nearly a week ago due to an increase in weakness, particularly in her neck, following even minor physical exertion. Apart from these symptoms, everything else aligns with typical presentations of MG. There has been a noticeable improvement in her facial weakness while on Mestinon; however, she experiences a return of weakness once the medication's effects diminish. Additionally, she has encountered intermittent episodes of severe shortness of breath, which she previously attributed to costochondritis, a condition also complicated by her rheumatoid arthritis. Recently, these breathing difficulties have escalated, occurring almost every evening, particularly following physically demanding days. She describes the sensation as a severe, constricting pain in the chest and rib area, making it challenging to breathe comfortably, especially when in an upright position. Is this a common experience, or should she consider consulting her neurologist about these symptoms?
Answers (1)
12/11/2025, 11:50:32 PM
OpenHealth AI
It's important to address your concern regarding worsening shortness of breath in the context of Myasthenia Gravis (MG). While some symptoms relate to MG, the severity and consistency of your breathing difficulties, especially given your history of rheumatoid arthritis and costochondritis, warrant careful attention.
1. Understanding Your Symptoms:
- Myasthenia Gravis can affect respiratory muscles and lead to difficulties in breathing, particularly during periods of fatigue.
- The description of constricting chest pain, especially with exertion, may suggest a multifactorial issue involving both MG and potential contributions from costochondritis or other conditions related to your rheumatoid arthritis.
2. Next Steps and Actions:
- Monitor Your Breathing: Keep a record of when the shortness of breath occurs, its severity, duration, and any known triggers (e.g. physical activity, position changes).
- Rest and Avoid Triggers: Ensure you give yourself adequate rest, particularly after physical activities that may exhaust you.
- Medication Timing: Note how the timing of Mestinon affects both your muscle strength and respiratory function. This information can be useful when discussing your symptoms with your healthcare providers.
3. Consultation:
- Neurologist Appointment: Given the escalation in your breathing difficulties, particularly as they are occurring frequently in the evening after exertion, it would be wise to consult your neurologist. They can evaluate if the breathing issues are directly related to MG or if another underlying condition is at play.
- Pulmonary Evaluation (if necessary): Depending on the findings from your neurologist, you might also need to see a pulmonologist who can help evaluate your lung function and rule out other respiratory conditions.
If you experience any sudden worsening of symptoms, such as significant difficulty breathing, chest pain, or if you feel faint, seek medical attention immediately. Your safety is paramount, and ensuring you have ongoing support from your healthcare team is crucial. Keep monitoring your symptoms closely, and consider reaching out to your neurologist soon.
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