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Shortness of Breath/Chest Tightness
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Shortness of Breath/Chest Tightness

A few days ago I randomly started having some shortness of breath that seemed to come about in episodes. They last anywhere from 30 minutes to 2 hours and during this time while I am able to breath, it feels sort of constricted or that I am unable to get a satisfying breath of air. I've never been diagnosed with asthma, but I do smoke cigarettes although I have severely cut down since this started happening 5 days ago. I've also had a feeling of tightness in my chest that seems to come and go as well, which can happen either with the shortness of breath, or it can present on its own. It almost feels like something is grabbing me from the inside, will last for 30 minutes to an hour, and then go away as well.

I do have some generalized anxiety, but in the years that I've had it, it has never presented as symptoms like these. I've also been taking buspar for the last two years which seems to keep my anxiety levels down anyway (although I'm sure there is some anxiety while I'm having one of these "episodes"). It seems to be happening 5-7 times per day randomly whether I'm at rest or being physically active does not seems to make any difference.  The last 24 hours or so I haven't had the tightness in my chest as often as the shortness of breath. My wife is prescribed an albuterol inhaler which I have used during one of these attacks which brings no relief whatsoever. I have no cough, no phlegm, but I did have a wheeze when I woke up in the morning today. I'm 26 years old, 160 pounds, and 5"8, and although I don't exercise as much as I should I don't think I'm in that bad of health.

I have a doctors appointment tomorrow evening so I am going to get checked out, but I wanted to see if anyone had any ideas of what this could be.

Any help or insight would be appreciated.

Brian
242587_tn?1355427710
At age 26, there are a number of possibilities that might be responsible for your episodes of shortness of breath.  You have mentioned two common causes:  asthma (a common cause of adult wheezing) and anxiety.  Anxiety is sometimes accompanied by what is called Panic Disorder and anxiety with panic accompanied by a condition called Vocal Cord Dysfunction (VCD), an abnormal closure of one’s vocal cords, mostly seen with inspiration.

Another possibility would be an abnormal heart rhythm that might or might not be experienced as palpitation and experienced as chest tightness.

The  best approach to your problem would include an assessment for lung disease (Pulmonary function tests and a Chest X-ray, for starters, with perhaps a treadmill test later) and heart disease with the Chest X-ray, EKG and ambulatory cardiac monitoring for 48-72 hours, along with your keeping a diary.

The key to the approach should be to diagnose or rule-out major organ disease (lungs, heart and what are called “the great vessels).  If all reports are normal and I hope that will be the case, it might be wise to reconsider your anti-anxiety therapy.

Good luck
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