pregnant chest tightness not asthma

[Breath1]

I'm 10 weeks prgnt have tihgtness in my chest conitunuous day/night causing shortness of breath. I've had a cough (no plegm just wheezing) I thought to be associated with my asthma for about 5 months, did not have it looked into until I found out I was prgnt 2 mnths ago. Cough appears to be from untreated bronchitis.A severe asthma attack brought me to the ER for an albuterol and oxygen treatment, did not help. Primary doc put me on QVAR inhailer 2xs day, after 4 days of continued coughing/wheezing I went for a 2nd opinion. 2nd primary doc took me of the QVAR inhailer and ordered me a nebulizer to take 2x daily with pulmicort, and every 4 hours with albuterol as well as Flovent inhailer 2xs daily. 1 week and I was still having severe chest pain, tightness and shortness if breath. My OB then suggested a pulmonologist, who took me off all the other remedies and put me on Advair 500 2xs day, Spiriva inhailer 1x day, sigulair 1 a day, and albuterol inhailer for emergenies. 2 weeks and was back in the ER. Went back to pulmonologist and he put me on Advair 250, Prednisone 10 days, still singulair (not related, I am hypothy and take synth 100). ER tried an albuterol trtmnt, didn't do a thing, did a blood test that ruled out clots and suggested possible pleurisy. Pulmonologist says probably not and that the test for that is not suggested while I am pregnant, and he suggested it was costochronditis. All times at ER my blood oxygen has been 100%. Predns has not helped. What next for tests? The tightness and smothered feeling continues? What could this be?

[National Jewish]

Pregnancy can cause asthma to change.  For one-third of women with asthma, pregnancy will make their asthma worse.  Since your symptoms are not helped by asthma medicines, this may be vocal cord dysfunction (VCD).  This is a condition that can mimic asthma.  However, VCD is not helped by asthma medicines.  While inhaling the vocal cords should open to let air into the lungs.  With VCD the vocal cords close together during inhalation.  This makes it difficult for air to get into the lungs.  A lot of the same things that trigger asthma can trigger VCD including upper respiratory infections, fumes, odors, reflux, cigarette smoke, singing, emotional upset, postnasal drip and exercise.  Sometimes the trigger is not known.  These attacks are also often seen with panic attacks.  Testing needs to be done while you are having symptoms.  Generally testing for a breathing problem starts with a simple breathing test called spirometry.  This test provides detailed information about how your lungs are working.  It may be normal, but the “breathing in” or inspiratory part, also called an inspiratory flow volume loop, will show little airflow while you are inhaling.  A laryngoscopy is a procedure done by a specialized doctor using a small camera at the end of a flexible tube to see how your vocal cords open and close.  VCD is treated by a speech therapist who will instruct you in the open throat breathing technique.  Counseling can help you identify and deal positively with chronic stress, which may be an underlying factor in VCD.  Please read our vocal cord dysfunction information at http://www.nationaljewish.org/disease-info/diseases/vcd/index.aspx to learn more.  It is important for you to be evaluated by a doctor to determine the diagnosis and appropriate treatment.