chest pain, wheeze, no cough

[bluebell646]

I have a blocked nose and wheeze with slight chest pains all over. I do not have asthma and the wheeze is not severe but i have had it for around 3 weeks. It is worse when lying down at night. It started when i felt i pulled a muscle on my left side and experienced chest pains for three days. This disappeared but has come back. Last night i also awoke with heart fluttering sensations. The chest pains feel like short stabbing pains which seem to move all over the chest area rather than the previous pains which were only on one side. Any ideas? 21year old female who is otherwise healthy. Thanks!

[Bhupinder Kaur, MD]

Hello,

I’m glad you had yourself evaluated by your doctor.Atleast the serious causes have been ruled out.The doctor is roght in saying that this wheeze can be due to viral infections.You had recurrent bouts of cold recently which can be responsible for this. Viral infections like a cold can cause inflammation of the airways of the lungs.  This inflammation can cause coughing and wheezing.  After the cold is gone, it is possible for the inflammation to last for several weeks to months. This is called reactive airways disease (RAD).Symptoms are close to asthma.It can be diagnosed only be chest auscultation as spirometry is not always useful.Treatment is by inhalational steroids and oral steroids in severe cases.

Secondly as you have asked,anxiety esp. panic attacks can cause chest pain and increase fluttering of the heart. A panic attack is a response of the sympathetic nervous system (SNS). The most common symptoms may include trembling, dyspnea (shortness of breath), heart palpitations, chest pain (or chest tightness), hot flashes, cold flashes, burning sensations (particularly in the facial or neck area), sweating, nausea, dizziness (or slight vertigo), light-headedness, hyperventilation, paresthesias (tingling sensations), sensations of choking or smothering.

Stress is an important causing factor. When you have such kind of symptoms, Breathe slowly through the nose using the diaphragm and abdomen. Do not breathe through the mouth. Talking with a supportive person — someone who has experienced true panic attacks personally; someone who is highly trained in treating panic attacks; loved ones who can offer support and comfort.Antianxiety medicines(available only on prescription)are also helpful.

Although I feel that your symptoms can be cold or anxiety related,but cardiac causes need to be ruled out.Atleast an ECG should be done so that no possibilities for cardiac problem remain.

Hope it helps.Take care and God bless.

[bluebell646]

so the doctor said it is probably just a viral wheeze and should pass(a week ago). I still have the wheeze and intermittent chest pain. The chest discomfort seems to go away for a number of days and then come back at night only. Again short stabbing pains. I do not have a cold or cough. I am however more breathless on exertion. I am concerned as one of parents had blood clots in their lungs last year with very few symptoms. After my docs appointment i thought I must just be too anxious and I'd hate to waste their time again. Is it possible to experince these things through anxiety?

[bluebell646]

Hi, thanks very much. I have had a number of colds in the last year and one a few weeks ago. However, I have not experienced any more heart fluttering sensations and i am not short of breath.  I will make an appointment first thing.  

Thanks

[Bhupinder Kaur, MD]

Hello,

Your symptoms are suggestive of lower respiratory tract infections and some lung pathology but cardiac causes also have to ruled out. Some causes of cheast pain(e.g., acute MI, unstable angina, thoracic aortic dissection, tension pneumothorax, esophageal rupture, pulmonary embolism) are immediately life threatening. Some (e.g., angina pectoris, pericarditis, myocarditis, pneumothorax, pneumonia, pancreatitis, various thoracic malignancies) are potentially life threatening.Others like emphysema,bronchitis,asthma,costochondritis,GERD,gall bladder disease and bronchilitis are not life threatening but need timely medical management.

I feel that a chest x-ray,ecg heart and CT chest will be helpful.Pls consult a respiratory physician and get it done at the earliest.

Hope it helps.Take care and pls do keep me posted on how you are doing