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What Causes Chest Tightness When Diagnosed With GAD And Asthma?
Question: I would like your opinion regarding my lung issue . I smoked for twenty two years. I quit 16 years ago. In the sixteen years I have taken 7 pft tests. The reason I began taking them was I had begun having Generalized anxiety disorder. My first issues with GAd were heart and lungs. This developed from a few sensations that triggered panic. Anyway I have GAD and in the 16 years a number of stressful events have amplified it.
Back to PFTs, the 7 tests have always been close and only change is the Fef 25/75 it is up then down then up then down ........ My last test 5 weeks ago was. Fvc 112. Fev1 98 fev1/Fvc 72 or 74. I forgot. Fef25/75 62 DLCO 98 rv103 tlc 112. After bronchodilator test all numbers stayed the same but fef25-75 went to 99%. I have relocated over the years and the pulmonologist that looked at these results felt no copd but there could be mild asthma. Maybe. He made statement that anxiety is causing me problems. Prior pulminologists with the three PFTs before this stated in his diagnosis. Asthmatic bronchitis. I have had a pulmonologist take a look at my PFTs and his response is that I have inflamed airways. No copd but stress is aggravating the inflammation and airways. That I should use a corticosteroid steroid to reduce inflammation and then stress relaxation and it should go back to how i felt three years ago. That is when I felt fine. That is when the panic really took over. I have upper chest tightness and my upper lungs do not comply to inhale as they used ton I do majority of breathing in lower belly breathing. That can be limited when I feel diaphragm is pressed on. Ok with all these diagnosis. I tend to think that I may have mild asthma but the stress is aggravating the asthma triggers and the inflamed airway. I will use the corticosteroid steroid to reduce swelling but I really need to know if any of this is what is keeping my upper lung from expanding as it once did and what should I do
Back to PFTs, the 7 tests have always been close and only change is the Fef 25/75 it is up then down then up then down ........ My last test 5 weeks ago was. Fvc 112. Fev1 98 fev1/Fvc 72 or 74. I forgot. Fef25/75 62 DLCO 98 rv103 tlc 112. After bronchodilator test all numbers stayed the same but fef25-75 went to 99%. I have relocated over the years and the pulmonologist that looked at these results felt no copd but there could be mild asthma. Maybe. He made statement that anxiety is causing me problems. Prior pulminologists with the three PFTs before this stated in his diagnosis. Asthmatic bronchitis. I have had a pulmonologist take a look at my PFTs and his response is that I have inflamed airways. No copd but stress is aggravating the inflammation and airways. That I should use a corticosteroid steroid to reduce inflammation and then stress relaxation and it should go back to how i felt three years ago. That is when I felt fine. That is when the panic really took over. I have upper chest tightness and my upper lungs do not comply to inhale as they used ton I do majority of breathing in lower belly breathing. That can be limited when I feel diaphragm is pressed on. Ok with all these diagnosis. I tend to think that I may have mild asthma but the stress is aggravating the asthma triggers and the inflamed airway. I will use the corticosteroid steroid to reduce swelling but I really need to know if any of this is what is keeping my upper lung from expanding as it once did and what should I do
Brief Answer:
You have Hyperresponsive small airways (In other words mild asthma)
Detailed Answer:
Hi,
Thanks for posting the query on HCM. After going through the query, I would like to comment the following:
1. You are an ex smoker currently with complaints of chest tightness and you have been diagnosed as GAD with mild asthma. The pulmonary Function Tests reveal Hyperesponsive small airways. Hyperresponsiveness is hallmark of asthma. You are lucky that the major airways seem to be OK at present.
2. Considering your clinical profile and investigations I tend to agree with your clinical diagnosis.
3. Your GAD needs to be managed absolutely with the help of a Psychiatrist. Also please follow up with a Pulmonologist regarding your chest symptoms.
4. Inhaled steroids will definitely help in reducing the inflammation of the airways that leads to hyperresponsiveness.
5. I would like to know if you have associated cold (Recurrent, seasonal or otherwise) ? Any past or present associated Burning pain in abdomen (You are on omeprazole)? Any known allergies? What is your occupation profile? Any exposure to any sort of inhaled dust/ fumes ?I would suggest an additional blood investigation - Absolute eosinophil count and serum IgE levels.
6. Continue your medications under medical supervision and regular clinical follow up with your doctors.
I will be glad to answer follow up queries if any. Please accept my answer if you have no follow up queries.
Regards
Dr. Gyanshankar Mishra
MBBS MD DNB
Consultant Pulmonologist
You have Hyperresponsive small airways (In other words mild asthma)
Detailed Answer:
Hi,
Thanks for posting the query on HCM. After going through the query, I would like to comment the following:
1. You are an ex smoker currently with complaints of chest tightness and you have been diagnosed as GAD with mild asthma. The pulmonary Function Tests reveal Hyperesponsive small airways. Hyperresponsiveness is hallmark of asthma. You are lucky that the major airways seem to be OK at present.
2. Considering your clinical profile and investigations I tend to agree with your clinical diagnosis.
3. Your GAD needs to be managed absolutely with the help of a Psychiatrist. Also please follow up with a Pulmonologist regarding your chest symptoms.
4. Inhaled steroids will definitely help in reducing the inflammation of the airways that leads to hyperresponsiveness.
5. I would like to know if you have associated cold (Recurrent, seasonal or otherwise) ? Any past or present associated Burning pain in abdomen (You are on omeprazole)? Any known allergies? What is your occupation profile? Any exposure to any sort of inhaled dust/ fumes ?I would suggest an additional blood investigation - Absolute eosinophil count and serum IgE levels.
6. Continue your medications under medical supervision and regular clinical follow up with your doctors.
I will be glad to answer follow up queries if any. Please accept my answer if you have no follow up queries.
Regards
Dr. Gyanshankar Mishra
MBBS MD DNB
Consultant Pulmonologist
Above answer was peer-reviewed by :
Dr. Prasad
Just an occasional cold
No burning in abdomen
I am an accountant
I live in an area of farming with dust, animal feces smells, and I moved into to this home and I have cats , and the house is old and musty.
No burning in abdomen
I am an accountant
I live in an area of farming with dust, animal feces smells, and I moved into to this home and I have cats , and the house is old and musty.
Brief Answer:
You do have allergic triggers for asthma
Detailed Answer:
Hi,
After going through the follow up information, I would like to comment the following:
1. You do have allergic triggers for asthma. Avoid all sorts of inhalational exposures.
2. Get these investigations done - Absolute eosinophil count and serum IgE levels.
3. Continue your medications under medical supervision and regular clinical follow up with your doctors.
4. As per your clinical profile I am in agreement with your current diagnosis of GAD with Bronchial Asthma. Inhaled steroids would improve the airway inflammation.
I will be glad to answer follow up queries if any. Please accept my answer if you have no follow up queries.
Regards
Dr. Gyanshankar Mishra
MBBS MD DNB
Consultant Pulmonologist
You do have allergic triggers for asthma
Detailed Answer:
Hi,
After going through the follow up information, I would like to comment the following:
1. You do have allergic triggers for asthma. Avoid all sorts of inhalational exposures.
2. Get these investigations done - Absolute eosinophil count and serum IgE levels.
3. Continue your medications under medical supervision and regular clinical follow up with your doctors.
4. As per your clinical profile I am in agreement with your current diagnosis of GAD with Bronchial Asthma. Inhaled steroids would improve the airway inflammation.
I will be glad to answer follow up queries if any. Please accept my answer if you have no follow up queries.
Regards
Dr. Gyanshankar Mishra
MBBS MD DNB
Consultant Pulmonologist
Note: For further follow up on related General & Family Physician Click here.
Above answer was peer-reviewed by :
Dr. Deepak
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