inspiratory flow

[maverick3934]

Hi, for the last 6 years I've had chest tightness and a feeling where it feels like I can't get a deep breath in. But after a few tries I can finally get that deep breath. Doctors have done pulmonary function tests which are completely normal over the period of 6 years. CT scan of sinuses normal, ct scan of lungs normal. I've gone to the hospital when I've had these "attacks" and all tests were completely normal. Is there anything this can be to cause the sensation of tightness in the upper chest?

[hava]

I will tell what you can do to help yourself.
There are two breathing techniques(pranayam) which will help you. Do the Ujjayi for 5 to 7 times daily and anulom vilom for 15 to 20 minutes, twice a day.
Build up your timing gradually.If you feel tired or dizzy, stop and resume after one minute.
Anulom Vilom pranayam –
Close your right nostril with thumb and deep breath-in through left nostril  
then – close left nostril with two fingers and breath-out through right nostril  
then -keeping the left nostril closed  deep breath-in through right nostril
then - close your right nostril with thumb and breath-out through left nostril.
This is one cycle of anulom vilom.
Repeat this cycle for 15 to 30  minutes twice a day.
Children under 15 years – do 5 to 10 minutes twice a day.
You can do this before breakfast/lunch/dinner or before bedtime or in bed.Remember to take deep long breaths into the lungs.You can do this while sitting on floor or chair or lying in bed.

Ujjayi pranayam
Procedure: While breathing in, tighten throat(contract glotis) and there will be sound from back of throat, then drop chin(rest chin on chest), hold breath as long as possible.Then  chin up, close right nostril and slowly breath out through left nostril.
Duration: 5 – 21 times

How to do Ujjayi
When you clear your throat, you tighten your throat and breath out, twice, with a pause in between. . Now if you reverse this, that is, tighten the throat and breath in continuously for abour 8 to 12 seconds, then hold your breath for 4 seconds with the chin down, then  chin up, close right nostril and slowly breath out through left nostril, you have just done Ujjayi pranayam.You will feel like coughing initially.

Your feedback at some point will help others as well.
September 9 ,2011

[David Tinkelman, M.D.]

What you describe suggests that you may be having what is called upper airway obstruction, the most common cause of which, when the symptom of chest tightness are chronic (6 years by your account) occur when breathing-in as with attempting to take a deep breath, is Vocal Cord Dysfunction or VCD.  This is a clinical condition in which one’s vocal cords partially close (inappropriately) during inspiration, resulting in obstruction to air flow and the sensation of “tightness.”  This is a not uncommon diagnosis, not associated with structural abnormality of the larynx or vocal cords and, one that can mimic asthma.

You note that repeated pulmonary function tests have been normal.  The diagnoses may be suspected on the basis of pulmonary function test results but only when inspiratory flow rate is measured and documented.  Not all pulmonary function tests include this information.  This abnormality may come and go, less likely to be seen at times when a person is experiencing seemingly normal breathing.  Confirmation of this condition, and the exam that will allow for other causes of your problem to be ruled out, is most reliably direct observation of your vocal cords via an instrument called a fiberoptic laryngoscope, by a physician skilled in its use, such as an ENT specialist or a Lung Specialist (pulmonologist).  The best time for this exam to be performed would be when you are experiencing the tightness in your chest.

I recommend that you check with your doctor regarding the possibility of an abnormality of your vocal cords or another part of your larynx or trachea.  In this same regard, a CT scan or MRI  of the larynx would be another diagnostic study, perhaps worthy of consideration.

Good luck