Shortness of breath and chest pain

[kim_osabi]

I need to find out what I could have. I have been having shortness of breath, a tightness/heaviness in my chest, chest pain at times, no wheezing can be heard by the dr with stethoscope so she is not leaning toward asthma. I've had normal heart tests (just got out of the hospital because of the chest pain & er thought I was having a heart attack), pulmonary function test was normal. I am 40, female, NEVER smoked or used drugs, no alcohol usage. I moved to the state I live in 2 1/2 years ago and it's one of the allergy zones supposedly. My dr put me on a flo-vent inhaler 2 puffs 2xs a day. I have a rescue inhaler and a nebulizer for when this "bronchospasm" gets really bad. My dr is not really sure what to do with me now since my heart and lungs seem perfectly fine. She is now thinking either GERD or an anxiety issue. I do not believe I'm having an anxiety issue. I can't say everything is perfect (no one can). However, I've stumped my dr and that scares me. She has requested a referral for allergy testing. Is it possible to have bronchospasm or asthma without a lung problem? Or should she order some other test(s) for me?

[kim_osabi]

I did even more research and figured out that I was prescribed Tricor about a month and 1/2 ago. I looked up Tricor's side effects and it seems that there can be a GERD type reaction and one commenter even said they had to go to the ER with chest pains. I stopped taking the Tricor and my GERD symptoms have much improved. I began generic prilosec and it didn't seem to help me. But stopping the Tricor has. My breathing has improved. But that could be that it's fall here now and that we're out of the "allergy season" or whatever was triggering that has stopped pollinating. My dr is referring me for allergy testing. So I'll see if that was it.

Thank you for commenting. This has been so frustrating! My dr told me to go home and take Valium. Yes, anyone can do with some calming down. But that wouldn't have solved the problem. I went for a 2nd opinion and basically told the other dr what I've tried and what has worked. Once my GERD symptoms calm down, I'm starting Niacin and Omega-3 fish oil for the high cholesterol.

[David S. Wilson, MD, FCCP]

You may want to obtain an order for an echo to rule out pulmonary arterial hypertension as well.  You sain that you had an ER visit.  They probably did an EKG.  An echo will show pressures in your heart that could possibly mean high blood pressure in the lungs.

[bsmsl]

It sounds like GERD is a good direction to investigate.  You can try life style changes - not eating (or drinking anything other than water) within 4 hours of going to bed, avoiding spicy or caffeinated foods and drinks, sleep with the head of your bed elevated at least 6 inches.  Taking a proton pump inhibitor (omeprazole) or an H2 blocker like (pepcid or ranitidine).  There are a few other options out there, but I can't think of their names.

Asthma is still a possiblity.  You may want to request a methylcholene challenge (sp?).  That is the definitive for diagnosing asthma.  The problem with PFT is that everything is compared to a sample population norm (take a sampling of 40 year old females and average their test scores).  You could be WAY higher than the average, but since you tested near the norm they say you are ok.  That happens with me.  I can go to the dr with a PFT of 93% and be declared ok, but for me that is way low.  When I am healthy my PFT is around 120%.  I have done 118% with pneumonia.  

I really suggest you investigate GERD first.  You could request an EGD (a scope of the esophagus-g (stomach)-duodenum) or Ph probe.  Or if your doctor would prefer you try some of the GERD meds first that would be good too.  GERD can be "silent" (no symptoms) as in laryngeal-pharyngeal reflux.  This could be the sole cause of your chest pain and respiratory symptoms.  

Good luck and keep us posted.