What could possibly be wrong?

[pbrit]

I am a 34 year old non-smokiing male that is 30 pounds overweight?  I have been very healthy all of my life and have very minimal family history of heart disease.(1 Grandfather)  On several occations in the last month after excercising I have had some strange symptoms appear following cool down.  My throat feels like its tight around my laranyx and I find myself breathing deeper and a head ache on the sides of my head.(these symptoms can occur for 6 hours)  It has lead to sort of a panic attack on 2 occations where I get extreme chills and slight disorientation breathing deeply but not a noticably restricted airway. Once I took a dose of albuterol because the attack was so severe.It appeared to lessen the intensity and I was able to get back to sleep. I have visited the Dr. and had a blood work up and everything was fine.  I might add that these symptoms only seem to occur at night as I am preparing to go to sleep or resting on the couch. They never occur during the activity.
I have been on previcid for the last 4 months as I had bronchitis during the summer.  The Dr. discoverd Acid Reflux(which runs in my family).  I have not been consistent with the previcid but I am currently taking it.  Could this be the symptoms of Heart Disease or a Gastroenterology issue?  I have not experienced any significant chest pain or arm pain.
Now it seems to have a placebo effect when I go to sleep as I am afraid that the attack will occur or something worse could be happening.  From time to time I take Pepcid AC and some belching will temporarily relieve some of the throat tightness.  It has only minimal-temporary effects.  The blood work did check for ulcers and was negative.

All of these symptoms also occur when not exercising but just not at the same intensity.  I might add that sleeping on my side seems to be the easiest on the condition, as sleeping on my stomach or back aggrevates it.

Please give me some suggestions as to what you think is wrong and what type of physicians I should see and tests I should undergo if any.

[Kevin Pho, MD]

Throat constriction can be caused by a variety of conditions, including GERD, asthma, allergies to name just a few.  To test for GERD, an upper GI series or 24-hr pH study can be considered for a more definitive diagnosis.  Certainly Prevacid or Pepcid are appropriate medications to treat this.

I would also consider PFTs (pulmonary function tests) to evaluate for asthma - if present, a steroid inhaler may be prescribed in addition to the albuterol for optimal control.  

If these tests come back negative, an ENT referral can be considered looking for any conditions that may constrict the throat (via a laryngoscopy) or a cardiology referral to look for heart disease (via a stress test).  

Followup with your personal physician is essential.

This answer is not intended as and does not substitute for medical advice - the information presented is for patient education only. Please see your personal physician for further evaluation of your individual case.

Kevin, M.D.
Medical Weblog:
kevinmd_b

[Special K67]

I have been on Nexium for the past month, and I have experienced similar symtoms.. I get nervous because I also have panic attacks which do not seem to help.  I have done some research on these meds and some of the side effects are chest pain and shortness of breath, but I am gonna go for further test to see what the real problem is

[retirednurse]

Hi, I was interested to read your symptoms as I have been having similar probs and my Dr seems to brush it off as panic, but I know that it isn`t! Mine started early December 04 with a visit to ER for chest/back pain, heart flutter snd throat constriction with dizziness. Gerd or an ulcer are suspected (awaiting gastrocopy) & I was put on Lanzoprazole & Gaviscon. This had no effect. I was/am having to live on soup as any solid food seems to sit there for hours and caused excess gas which brought on the constriction/dizziness.Bending also brings it on. Seemed also at times as if my diaphragm was fluttering in spasm, which triggered bad shaking attacks, which I think is where the panic theory came in.My Dr put me on beta blockers (propranalol 40mg 3 x day)for the spasm (also helps anxiety and prevents angina) and Nexium 40mg 1x day and this has significantly improved the symptoms.It still happens, but not as bad, and I  still have to avoid high residue food and bending though..any indulgence brings it all back on, so obviously it`s masking not curing.Roll on the gastro...
Hope my experience may help others, or I`d be interested to hear from anyone else with similar symptoms.