<s>[INST] I am a 24 year old female I work out quite regularly and for the past 2 months I have had this chest cold. I went and bought a new sabutomal puffer today and since started taking that I have been projectile vomiting every time I take my inhailer. It is my only way I can breath at the moment but I can t take it due to me vomiting. Should I be going in to the emergency. I also have asthma and I had a hole in my heart repaired as well as a valve closed. Is there some sort for concern here. [/INST] Hi,Thank You for giving us the previlege to answer you here on HealthcareMagic,Your breathlessness needs to be evaluated whether it is related to cardiac aetiology or is it your asthma flaring up.You have just now got yourself a new Salbutamol Inhaler. One common problem is improper technique of use. If it is an pMDI (pressurised Metered Dose Inhaler) it's best to use a Spacer (A device that helps in delivering the medication to the smaller airways while minimising deposition in throat).If you are Asthmatic, you must be on ICS/LABA Inhalers (Inhaled Corticosteroids/ Long Acting Beta Agonists). If not you need to have an 'Action Plan' devised to keep your asthma under control.Investigations: Chest Xray                      Blood Counts                      SpirometryVomiting part can be got over by proper inhaler technique and T. Ondensetron 4mg thrice a day shall help in tiding over till you get evaluated.Hoping I have helped you with your query,Wishing you Good Health,Take Care. </s>