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Chronic Obstructive Pulmonary Disease (COPD) Forum
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Avatar universal

Is this COPD?

Two weeks ago I began having chest pains and shortness of breath. Other symptoms include nighttime palpitations, aches in my neck/back, random pains in left arms.  Chest pain is typically oriented on the left-side.  I went to my family doctor and he listened to my lungs and told me I had bronchitis (I had had no cough, nor had a coffee at any time in the last few weeks).  He prescribed Albuterol, ipratropium bromide, antibiotics, and an expectorant and cough supressant.  He also sent me to the hospital for a chest-xray and blood tests.

Ten days later I went back to see him for a followup and my breathing was much better after the Nebulizer use, but I was still having random chest pains.  The chest x-ray showed borderline hyperinflation and my doctor explained to me this meant COPD.  I have been exposed to second-hand smoke most of my life, smoked myself for about a year and a half, but I am only 20 years old and he was simply amazed that I have COPD.   He did an ECG and it was showed a right bundle branch block.  He referred me to a cardiologist the next day and I did a stress echo the next morning.  The next day I went to the cardiologist and he did another ECG in the office, and both the stress echo and ECG done by the cardiologist showed NO RBBB at all, and the doctor told me my heart was in perfect shape.  So if the chest pains are not originating from my heart, my best guess is they're from my lungs.  Typically I do not have the pains during the day, but usually in the evening after I've been working for a while.

Has anyone heard of a 20 year old person, a smoker for less than two years, developing COPD?  I do not have insurance, would it be worth the cost to go see a pulmonologist?
4 Responses
242588 tn?1224271700
MEDICAL PROFESSIONAL
You are right to conclude that the chest pain is very unlikely to be originating in your heart.  At age 20, your heart is most likely to be “in perfect shape.”  And, the isolated finding of right bundle branch block (RBBB) is common and, in the absence of any other sign of heart disease, considered to be a clinically insignificant finding.  What the cardiologist said about no RBBB should be the last word on this.  Pain seldom originates in the lungs themselves, with the major exception of pleuritic pain, called pleurisy, which actually originates in the membrane which envelopes our lungs.

Borderline hyperinflation can be seen with asthmatic bronchitis, with asthma, with chronic obstructive pulmonary disease (COPD) and with a number of uncommon lung diseases, especially at age 20.  Asthma and your recent bout of bronchitis would be the most likely cause of mild hyperinflation, not COPD.  In addition, borderline hyperinflation is a rather subjective observation; one radiologist may see it when another reading the same x-ray, does not.  Besides, while it can be an early sign of COPD, it is not at all the best way to make the diagnosis.  Pulmonary function tests (PFTs) are the best way and, if you are still not reassured by my response, you should ask your doctor to order PFTs.

There is a condition called alpha-1 antitrypsin deficiency with which one can develop COPD at an early age.  It accounts for less than 2 to 3% of disease in all people with COPD.  It is a simple blood test and, should doubt about the diagnosis of COPD linger, as could happen with borderline PFTs, it would be appropriate to do the blood test.

The bottom line is that the odds are in your favor and it is highly likely that you have nothing to be concerned about.

Good luck.
587315 tn?1333552783
Hi, COPD is NOT common in a 20 yr old w/ a light smoking history.  There is a condition called Alpha 1 that causes a genetic form of emphysema(also a form of COPD) that can be tested through a blood test.  I hope that was the blood test that your doctor ordered for you.  You really need to request pulmonary function tests (breathing tests), that can completely rule out emphysema.  The x-ray can't diagnose emphysema-ONLY the breathing tests can do that.  Your doctor shouldn't have told you that you have COPD.  I just don't get why doctors scare us like that!  Anyway, lung hyperinflation can also be caused by asthma.  Did your doctor mention that?

Good luck to you!  The pulmonary function test will be money well spent, and you might be able to get the test discounted since you don't have insurance.  I had it done at my local hospital and didn't get charged for it because I don't have insurance either.  Start calling around to your local hospitals and tell them your situation, because you really need to get this test done.
Avatar universal
I have COPD with ashtma and emphysema and have no pain in my chest at all.  
Sounds like you may have ashtma, but they need to check your heart again.  They missed something.
Avatar universal
HI,
Hyperinflation can be from poorly controlled ashtma, it does not necessarily mean copd. I would bet it is ashtma related.
You definetly need a pulmonary function test.
I know going to specialist is expensive when you don't have insurance, but I think it would be money well spent. You would get to the bottom of it and if the hyperinflation is caused from your ashtma not being taken care of properly you would get the proper treatment that way too.
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