COPD or Asthma?

[Mano1]

33 yr old female - smoker since 16.  Went to the doctor with chest pain - generalized aching rather than stabbing pain.  Headaches. Tiredness + pain on left side when lying on left.  Doctor ordered a chest + sinus x ray which shows hyperinflated lungs and fairly prominent basal bronchovascular markings + dorsal spine osteophystes. Also sinus infection. Doctor first said it was emphysema and now says its asthma?!  Never had asthma in my life - please help....is it pointing to a COPD disease or what is it....

[National Jewish Health]

You are actually asking 2 questions:  1) about your acute symptoms; and 2) about chronic lung disease due to smoking.  Generalized aching chest pain, headaches and tiredness suggest influenza or a flu-like syndrome.  The lung hyperinflation and “…prominent basal bronchovascular markings…” could be signs of the effect of smoking on your lungs; that is, signs of early chronic lung disease, such as chronic obstructive pulmonary disease (COPD).  The question of asthma vs COPD is not one that can be resolved by chest x-ray, but one that will require a careful history and pulmonary function tests (PFTs).

While still young, you have smoked for a long time and these x-ray changes may well be a sign of COPD.  If so, and if that diagnosis is confirmed by PFTs, you should take that as a sign that cigarette smoke is damaging your lungs and, should you continue to smoke, the COPD will only get worse and relatively fast, with clinically significant COPD by the age of 50, which is still young.

Good luck.