• Published on: Jul 14, 2021
  • 1 minute read
  • By: Raj Dwivedi

Telemedicine, COVID-19 And Liver Diseases

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  • For liver diseases, there have been successful experiences with the use of different modalities of telemedicine [i.e. asynchronous telemedicine (analysis of patient's data by a single physician or multidisciplinary team), synchronous real-time patient management and tele-education]
  • Our Telemedicine program showed successful results as the sustained virologic responses achieved by those patients treated in primary care settings under the expert guidance.
  • Currently, this type of care is considered a vital tool for the goal of global elimination of HCV infection.In addition to HCV management, telemedicine offers opportunities for a better management of patients with chronic liver diseases by increasing their access to tertiary care, thus improving efficiency of healthcare delivery at reasonable cost .
  •  We forsee expansion of telemedicine into other areas of hepatology is desirable and hold potential for improving management of pre- and post-liver transplant patients, patients with hepatocellular carcinoma (HCC) and patients with both compensated and decompensated cirrhosis.
  • It is important to note that in liver transplant setting existing data suggest that use of telemedicine may expedite evaluation and listing of patients referred to liver transplant centers and could improve outcomes (hospital readmissions, and quality of life) after liver transplantation.
  • In the case of HCC, telemedicine aslo offers the possibility of multidisciplinary evaluation in virtual tumor boards leading to tailored and more effective treatments . Finally, in cirrhosis, telemedicine may enhance self-care and facilitate HCC surveillance eventually preventing readmissions in recently hospitalized patients.
  • With the onset of COVID-19 pandemic everyone has forced the implementation of telemedicine actions for many liver patients.
  • Major international societies have released recommendations encouraging the use of remote care to manage patients with all liver diseases, particularly liver transplant patients.
  • However, the crisis will seriously impact cirrhosis care with social distancing and isolation causing major delays in elective procedures and routine care with potential overwhelm of medical centers managing postponed and potentially decompensated patients in the upcoming months.
  • Developing robust telemedicine programs and revamping remote care initiatives in hepatology will be critical during COVID times. The next challenge will be how to integrate telemedicine into routine clinical care beyond the COVID-19 pandemic.
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Chest pain

Chest Pain While Breathing: Causes, Warning Signs, and When to Seek Urgent Care

Chest pain is one of the most alarming symptoms a person can experience, especially when it worsens during breathing. Chest pain while breathing, also known as pleuritic chest pain, often indicates involvement of the lungs, chest wall or surrounding structures. While some causes are mild, others can be life-threatening and require immediate medical attention.

In India, respiratory infections, air pollution, sedentary lifestyles and delayed medical care contribute significantly to chest-related symptoms.

 

What Does Chest Pain While Breathing Mean?

Chest pain while breathing refers to pain that:

  • worsens with deep inhalation or exhalation

  • may feel sharp, stabbing or burning

  • can be localized or spread across the chest

Pain intensity often increases with coughing or movement.

 

Common Causes of Chest Pain While Breathing

Lung Infections (Pneumonia)

Pneumonia inflames lung tissue and surrounding membranes.

Symptoms include:

  • chest pain while breathing

  • fever

  • cough

  • breathlessness

ICMR data identifies pneumonia as a major cause of respiratory illness in India.

 

Pleuritis (Inflammation of Lung Lining)

The pleura are thin membranes surrounding the lungs.

When inflamed:

  • breathing causes friction

  • sharp chest pain occurs

Pleuritis often follows viral infections or pneumonia.

 

Pulmonary Embolism

A blood clot in the lungs causes:

  • sudden chest pain

  • rapid breathing

  • severe breathlessness

This is a medical emergency requiring immediate care.

 

Chest Wall Muscle Strain

Muscle strain due to:

  • heavy lifting

  • intense coughing

  • poor posture

can cause pain during breathing or movement.

 

Costochondritis

Inflammation of rib cartilage causes:

  • localized chest pain

  • pain worsened by breathing or pressing on the chest

This condition is painful but not life-threatening.

 

Pneumothorax (Collapsed Lung)

Air leakage into the chest cavity causes:

  • sudden sharp chest pain

  • breathlessness

Often seen after trauma or in individuals with lung disease.

 

Heart-Related Causes

Though heart pain usually does not worsen with breathing, conditions such as:

  • pericarditis (heart lining inflammation)

can cause chest pain that changes with respiration.

 

Acid Reflux and Esophageal Spasm

Gastrointestinal causes may mimic chest pain.

However:

  • pain usually relates to meals

  • breathing-related pain should be evaluated carefully

 

Anxiety and Panic Disorders

Anxiety can cause:

  • chest tightness

  • rapid breathing

  • discomfort while breathing

Medical causes must be ruled out before attributing pain to anxiety.

 

Warning Signs That Require Emergency Attention

Seek immediate medical care if chest pain while breathing is associated with:

  • sudden onset

  • severe breathlessness

  • bluish lips or fingers

  • dizziness or fainting

  • sweating

  • coughing up blood

These may indicate life-threatening conditions.

 

Risk Factors for Serious Chest Pain

Higher risk occurs in people with:

  • smoking history

  • recent surgery or long travel

  • lung disease

  • heart disease

  • clotting disorders

Early evaluation is critical.

 

Diagnostic Evaluation

Doctors may recommend:

  • physical examination

  • chest X-ray

  • ECG

  • blood tests

  • CT scan

Timely diagnosis saves lives.

 

Why Chest Pain Should Not Be Ignored

Ignoring chest pain can lead to:

  • delayed treatment

  • worsening respiratory failure

  • preventable complications

WHO emphasises early symptom recognition for better outcomes.

 

Impact of Air Pollution and Lifestyle

Air pollution increases:

  • lung inflammation

  • infection risk

Sedentary habits reduce lung capacity, worsening symptoms.

 

Preventive Measures

Helpful preventive steps include:

  • avoiding smoking

  • staying physically active

  • managing respiratory infections early

  • maintaining good posture

  • staying hydrated

Preventive care reduces risk.

 

Role of Preventive Health Checkups

Regular health screening helps detect:

  • early lung disease

  • heart risk factors

  • chronic inflammation

Early intervention prevents emergencies.

 

When Chest Pain Is Less Likely Serious

Pain may be less concerning if:

  • localized

  • reproducible on touch

  • improves with rest

However, medical confirmation is still necessary.

 

Importance of Timely Medical Consultation

Chest pain should always be evaluated by a healthcare professional.

Delaying care can:

  • increase complications

  • raise mortality risk

Early action saves lives.

 

Conclusion

Chest pain while breathing is a critical symptom that should never be ignored. While causes range from muscle strain and infections to serious lung and heart conditions, only proper medical evaluation can determine the exact cause. Early diagnosis, timely treatment and preventive care are essential to protect respiratory and cardiovascular health. When it comes to chest pain, it is always safer to act early than to wait.

 

References

  • Indian Council of Medical Research (ICMR) – Respiratory and Cardiovascular Health Reports

  • World Health Organization (WHO) – Chest Pain and Respiratory Symptoms Guidelines

  • National Family Health Survey (NFHS-5) – Adult Respiratory Health Data

  • Lancet – Pulmonary Embolism and Chest Pain Research

  • NITI Aayog – Preventive Healthcare and Early Symptom Recognition

See all

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