Exercise Induced Asthma or something else?

[Johnny B Good]

4 years ago I had a lung infection that was quite severe.  Since then, after I exercise, I experience tightness of breath, exhaustion and fatigue that can last 2-3 days at its worst.  At the time it could not be explained by my Doctor in spite of numerous tests (cholesterol, Treadmill EKG, Breathing capacity etc.)  I was also under a lot of stress and burned out during this period (complete exhaustion).  I had to limit vigorous exercise as any cardiovascular exercise would trigger it.  Prior to the infection, I had no problems with cardio exercise.  

After researching on the net recently, I thought I might have Exercise Induced Asthma and asked for Ventilin to try it out.  Good news, it worked!  I can exercise freely without the previous effects.  However, I now want to know what are the possibilities of what I have.  Is it possible that I have a chronic disorder/infection with my lungs that is not asthma?  I never wheeze or cough, just chest tightness.  (Heart problems were ruled out again recently).  Due to a short supply of doctors, I must resort to visits to a clinic in order to get medical attention and unfortunately with my experience, doing my own research has proven more successful.  Any guidance that will allow me to proceed with a doctor in a more informed manner will be greatly appreciated.  

P.S.  Stress also causes the chest tightness and the greater the stress the tighter my chest.  Fatigue / exhaustion will follow if the stress is high enough.

Thanks in Advance.

[National Jewish]

It is not uncommon for a lung infection to trigger lower airway symptoms.  The infection can lead to an increased airway irritability or hyperreactivity, which is often diagnosed as asthma.  If the irritability subsides, then the symptoms will go away over time.  If the irritability is just the triggering of ongoing asthma, then the symptoms will continue and ongoing treatment will be needed.  Also some people start to have problems with asthma only after having a lung infection, especially when the infection is severe.

Wheezing and coughing are certainly common symptoms of asthma.  However for some people chest tightness is their only symptom of asthma.  Exercise is a common trigger for asthma.  For some people it is the only thing that causes asthma symptoms.  In well-conditioned athletes, symptoms of exercise-induced asthma (EIA) may only occur with the most vigorous activity or exercise.  Stress can also trigger asthma.

An exercise challenge is a test used to determine whether or not EIA is the problem.  You will walk or run on a treadmill or ride an exercise bicycle.  Before and after this exercise spirometry is checked.  Spirometry is a simple breathing test that provides detailed information about how the lungs are working.  If the spirometry drops by 20% after exercising the test is positive for EIA.  If your doctor determines that you have EIA, a bronchodilator inhaler, like the Venotlin

[Ellis7]

To get a diagnosis, try requesting a Pulmonary Function Test.
http://www.nlm.nih.gov/medlineplus/ency/article/003853.htm
Pulmonary function tests

"Pulmonary function tests are a broad range of tests that are usually done in a health care provider's office or a specialized facility. They measure how well the lungs take in and exhale air and how efficiently they transfer oxygen into the blood.

Spirometry measures how well the lungs exhale. The information gathered during this test is useful in diagnosing certain types of lung disorders, but is most useful when assessing for obstructive lung diseases (especially asthma and chronic obstructive pulmonary disease, COPD).

Lung volume measurement detects restrictive lung diseases. In this set of diseases, a person cannot inhale a normal volume of air. Restrictive lung diseases may be caused by inflammation or scarring of the lung tissue (interstitial lung disease) or by abnormalities of the muscles or skeleton of the chest wall.

Testing the diffusion capacity (also called the DLCO) permits an estimate of how efficiently the lungs transfer oxygen from the air into the bloodstream."
-----------------------

You could also ask for referral to a pulmonologist.

[copersm]

Johnny

Your symptons/situation sounds similar to my problems as complications following a severe untreated pleural effusion. I have been under the care of a pulomonolgist and have been to Mayos. So far the exact damage has not been identified and the suggestions to me are basically learn to live with the problem. Which I do not want to do. I have not tried Ventilin which I will mention to Dr. at next visit.

copersm