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Forum Name: Chest symptoms

Question: Chest Heaviness/Tightness. Breathing shallow

ap10046 - Sat Dec 30, 2006 8:49 am

Dear Doctor Mahmoud, Good Day. I am a male, 31 years old, non smoker/drinker, 5'11" and 196lbs. I am usually always stressed and am constantly anxious. About a month and a half back, I woke at about 4am with this searing, stabbing pain in my right side back. it made breathing difficult so we ran to the ER which is only 5 minutes from home, where they immdiately did an ECG, blood tests, chest X-ray, sonography, and administered a pain killer. They kept me overnight for observation and discharged me soon after. All reports and the ECG were absolutely normal. The pain went away in a day but I got a Cough that lasted about 2 weeks (pretty heavy) and it still persists but only a little. After that, I felt a little discomfort/tightness in my middle chest sometimes right, rarely on the left. My back sometimes pains, very much like a bad nights sleep(I do slouch a lot). I also sit a lot at work, maybe 10 hours, then go home and lie on the bed. Very little activity. In the evenings, I do tend to get tired and exhausted and my breath seems shallow, this subsides after about 2 hours. I made another trip to the doctors, who found my pressure high. 140/110. I have a family history of high blood pressure. he gave me Nebicard SM twice daily, that has brought the pressure down to 130/96 within a week. I have undergone a rigourous checkup less than a year ago that entailed EEG, ECG, stress tests, sonograms, x-rays, blood tests, etc and apart from the pressure, everything was clear. Nebicard was issued then too, which I stopped after a month. Due to my always anxious nature, I am quite tense about this now and am constantly wondering about it. Please would you advice me on what to do. Thank you kindly Regards

Dr. Safaa Mahmoud - Sat Dec 30, 2006 4:54 pm

Hello, Your description is more likely to be due to respiratory tract infection and inflammation of the pleura (pleurisy). Inflammation of the pleura covering the lung gives a sharp pain that is associated with Cough and is more severe when taking deep breath. It makes also breathing very difficult. The condition is due to viral infection in most of the cases. You have mentioned that you suffer also from Cough, thus a viral infection is more likely to be the case, and it has affected his pleura. Inflammation in the respiratory airway results in spasm of the muscles of the bronchial way with swollen cells in the airway lining, as a sequence narrowing of the respiratory tract and decreased airflow. This results in Shortness of breath. The condition gradually improves with rest, plenty of fluid. NSAID can help reduce the pain. If you have a productive Cough with yellowish or greenish sputum, or high Fever, you should visit your doctor immediately to receive the proper medical care. In such cases, bacterial infection is possible to be the cause and unless you receive the proper Antibiotic it will be a prolonged attack and may be complicated. An additional cause for pain could be, Overexertion of the chest wall muscles or their inflammation as a part of viral infection like flu or cold results also in Chest pain, the pain is usually aggravated with certain moves and is usually associated with tenderness over the affected muscles. In all of these conditions the Chest pain is usually aggravated by taking deep breath and Cough. Sometimes spasm of the chest wall muscles occur as reflex to pain felt in the chest, this will make breathing more difficult and shallow. If your type of work, or your habits make you remain in certain inappropriate posture, the pain will increase and the spasm will not be relieved. Direct clinical examination is essential. Keep us updated. Best regards.

ap10046 - Tue Jan 02, 2007 5:42 pm

Dear Dr. Mahmoud, Thank you very much for taking the time to peruse my query. The Gp I visited seems to think it has to do with High Blood pressure. Although, it is not imposing, painful or uncomfortable, the feeling is making me extremely nervous. I will update on the forum soon. Thank you again and wish you a Very Happy, Healthy and Prosperous New Year!

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