<s>[INST] Hi doctor, I am a 50-year-old female, with a history of childhood asthma, that was virtually a nonissue in my adult life until three weeks ago. I had a recent SVF adipose stem cell treatment for OA with a cold on board. I felt tight chested then but not bad enough to take my Ventolin. A few days later, I developed a persistent tight chest and difficult exhalation that led to a respiratory admission for ?asthma or reactive airways. In spite of Prednisolone, Seretide, Ventolin, and Atrovent, I do not feel better. I am unable to work and doing very minimal things around the house because of the severity of the symptoms. My mother had COPD. I am frightened this is COPD and I am terrified actually. I am also scared that maybe the stem cells have caused an adverse lung reaction. I cannot continue to live like this. I have had a normal CTPA, normal CXR, normal echo, no growth in my sputum, and apparently a normal-looking lung function test that might be indicative of asthma (different people tell me different things). Please help. [/INST] Hello. I have gone through your symptoms and investigations thoroughly and your treatment records. (attachment removed to protect patient identity).  First of all, it is not a COPD (chronic obstructive pulmonary disease) and asthma as suggested by normal pulmonary function tests and normal chest x-ray. It is also very unlikely due to stem cell reaction as chest x-ray is normal. I have reasons to suspect that symptoms are not due to lungs rather due to heart the condition is known as cardiac asthma. I want to know one thing do you have swollen leg on both sides and are you on any antihypertensive agent. Congestive heart failure. ECG, Echocardiography. Atypical lung infection Cardiac asthma. Tablet Aldactone 50 mg (Spironolactone) one tablet thrice a day for five days.  Tab Monteluekast 10 mg 1 tab once a day at bed time for 2 weeks. Raise your head side while sleeping. Upload your echo and other reports. </s>