chest discomfort

[andy2176]

Hello.I have had an uncomfortbale feeling in my chest for the last three weeks. I am a smoker of about 8 years.  I am a 27 yr old male.  It started out as an uncomfortable feeling in my chest combined with some fatigue. No other symptoms.  Then I started to feel shortness of breath and pressure on my chest and I had an unproductive dry cough.  I could feel the phlegm or fluid in my lungs and nothing would come up.  I have a history of anxiety So i got really worried.  This just got worse as the days went on. I then had heart palpitations for about a week and they went away.  I have tapered of anti=depressant medication (paxil)to 10mg down from 15.  I really don't think this is related but I just wanted to run that by.  I have seen 2 different doctors and they gave me prescription zantac for  heartburn, and Q-bid for congestion.When I didthe asthma test I didnt blow normal for my lungs but the inhaler has helped that I was prescribed.  I have never had asthma of any kind up until this point. The chest x ray I took was normal and my heart rate was fine. THey declared me healthy and said my lungs and heart were fineboth doctors.I have a follow up appt thursday and was thinking of what I should say to my doctor? any other tests to run? Right now my symptoms are the chest discomfort,I feel run down, and I have an unproductive cough. I still feel the "fluid" in my lungs I have no idea what it is. THey told me I had none, but it just feels that way.  The inhaler has helped my shortness of breath and breathing is easier. I also have no heart palpitations right now. Any suggestions?

[National Jewish]

It is unclear from the information that you have provided if the testing you had done indicated that you have asthma.  Generally testing starts with a simple breathing test called spirometry.  This test provides detailed information about how your lungs are working.  It will show if there is obstruction in your airways.  To really test for asthma it is best to repeat this test after using a rescue inhaler, an inhaled bronchodilator.  This measures how much the bronchodilator helps your lungs by reversing the problem.  When there is a 20% increase the test is positive for asthma.

The symptoms that you have described could occur with asthma.  It’s good that the inhaler is helping and this would be expected with asthma.  Asthma causes inflammation or swelling that narrows the opening of the airways of the lungs.  In some people with asthma, the mucus glands in the airways make a lot of thick mucus that decreases the opening of the airways even more.  Using an inhaled steroid on a regular basis will decrease this swelling and mucus.  There is also tightening of the muscles that surround the airways of the lungs with asthma.  A quick relief medicine like the rescue inhaler used in testing for asthma, can relieve this bronchospasm by relaxing the tight muscles around the airways.  A variety of things called triggers can make asthma worse.  Heartburn is one of these triggers.  Zantac® (ranitidine) would help the heartburn.

At your follow up appointment on Thursday you should let your doctor know that the inhaler has helped with your shortness of breath and made your breathing easier.  Let your doctor know if the Zantac® (ranitidine) has helped your heartburn and if the Q-bid has helped your congestion, that feeling of phlegm or fluid in your lungs.  Also be sure to talk with your doctor about your concerns that caused you to decrease your dose of Paxil® (paroxetine).