5 months shortness of breath, is that Pulmonary fibrosis?

Dear all,

I am 23 years old male, having almost 4 months:
- shortness of breath(always/anytime), can not take deep breath.
- palpitation(sometimes)
- tingling sensation on my upper back, my finger and my foot (very often)
- dizzy, feeling weak.

I had a history on asthma, but my SOB didn't response to asthma medication. Recently, my doctor prescribed me Singulair, Allegra, Xopenex, Flovent (since he told me that my SOB is because of asthma). I did 3 chest x-ray tests (last one was 2 weeks ago, came out normal), spirometry test, EKG, Echo, holter monitoring, TSH blood test. All test were normal. With this SOB I can't concentrate while studying and doing another activities. My peak flow is around 500 L/min while the normal for my age and height is around 610. (I'm 5'7" high)

My questions are:
1. Is it possible that my SOB is because of Pulmonary Fibrosis/Interstitial Lung Disease? I was a motorbike rider when I was an undergraduate student. Is the exposure of air pollution (from vehicle for example) can cause Pulm. Fibrosis?

2. What  kind of test need to be done to know whether my SOB is because of Pulmonary Fibrosis or not?

3. Does normal chest x-ray result can rule out Pulmonary Fibrosis/Interstitial Lung Disease?Do I need to have CT scan on my  Lung?

Thank you very much

Heribertus

[National Jewish Health]

A normal chest x-ray, normal peak flows and normal spirometry would pretty much rule-out any type of interstitial lung disease, including fibrosis, especially if physical examination of your lungs is also normal.  Air pollution is not thought to be a cause of pulmonary fibrosis.  If all these tests are truly normal, no further testing should be needed to rule-out pulmonary fibrosis but the test that would do that, short of a lung biopsy, would be a high resolution CT (HRCT) scan.

A normal chest x-ray, alone, does not rule out the diagnosis of interstitial lung disease (ILD), but combined with the other normal tests, becomes a strong argument against the diagnosis.

Some of your symptoms resemble those seen with hyperventilation, which in turn is often seen with anxiety with panic disorder.  While a reflection of anxiety, panic can very closely simulate the symptoms and signs of lung or heart disease.  You should consider discussing this with your primary doctor, for panic disorder is a very treatable condition.

Good luck.