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Forum Name: Chest symptoms

Question: Persistent Tightness/Pains in Chest for Over 5 Weeks


 Young_Aussie - Mon Aug 06, 2007 9:49 pm

I'm a 22 year old male, and quit smoking 6 weeks ago. I smoked at least a pack a day for about 5 years. However between the ages of 14 and 18 I also smoked alot of pot and think that this may have had an effect on my lungs.

I have had acute bronchitis twice and have been hospitalised once with pnuemonia over the last four years, which is why I have finally decided and managed to quit. Apart from these respiratory problems in the past and my present problems I am healthy, I had a blood test 4 weeks ago and the only abnormality was raised levels of ALT (95) and Albumin (55) in the liver function test.

For the last 5 weeks (it began a week after I quit smoking) I have had a persistent tightness and feeling of discomfort in my chest, I just feel like I can't fill my lungs to full capacity and take a slow deep breath. It feels tight in my upper chest and it also feels like I hit a kind of wall in my lungs when I try and breathe deeply. The discomfort is most pronounced in the left side of my chest. I also get pains that come and go, some days I will experience little pain and other days the pain will be present almost all the time. These include aches down the left side of the chest, sharp and or dull pain in the middle of the chest, and or a tingling painful sensation in the middle of my chest. The pain will last for anywhere from 5 minutes to half an hour at a time, if I sit or lay down it becomes more managable. The tightness and discomfort in my chest is constant and I have had no relief from these symptoms for over 5 weeks now.. I also have a persistent productive cough bringing up white phlem and grey phlemp occasionally (tar I think).. I am also having heart palpitations every day or so. Cold air and physical exercise, even walking and lifting, seem to worsen my symptoms.

I have had a chest x-ray and this came back clear. I have had a spiro test and my lungs can hold 6 litres.
My doctor has eliminated asthma as a cause, and has found no problems in a blood test covering LFT, Renal function, Electrolytes, Glucose Random, FBC and ESR (I don't know what most of this means by the way). When I first saw him he thought it was a chest infection and prescribed me Moxiclav Duo Forte 875/125, after a week this had no effect so then he gave me Prexige Lumiracoxib, thinking that it could be due to muscle strain in the chest area. This also has not helped. I am now taking Roxithromycin to see if this will have any effect but I am not optimistic as I don't think I have an infection. My doctor did suggest it may be anxiety (I do get mild panic attacks from time to time, and self manage this), but I honestly don't feel that stressed at the moment, and the tightness and discomfort is constant, not being brought on by a panic attack. If anything I feel that the discomfort is causing me some anxiety (as I am prone to it), but my symptoms feel so physical and persistent, and I honestly feel good mentally apart from this, that I find it hard to beleive it is anxiety. I also do alot of walking normally so I am not deconditioned. My doctor has also suggested it may be a virus of some sort?

There is no history of heart disease in my family that I am aware of, however there is prostate cancer and cholesterol problems on my fathers side, and severe mental health issues on both sides of the family. I suffer from mild depression and anxiety from time to time but it is not disabling and not severe.

It has been 5 weeks and I am starting to feel like they will never be able to work out what it is. I'm going to a respiratory specialist in 2 weeks so hopefully he can help. Also my doctor said it isn't my heart, but from the tests he has conducted can he really rule that out as a possibility? I was not going to university or work as a result of my symptoms.. I am now back at university, doing what I can from home, but still feel definitely unfit for being on my feet for 8 hrs at work. My condition has overall not really improved since I woke up with my symptoms 5 weeks ago. Sorry this is such a long post, I just want to provide as much information as i can in the hope you may have an idea of what is causing my troubles.
 Dr. Chan Lowe - Tue Aug 14, 2007 7:33 pm

User avatar Hi Young_Aussie,

I'm not sure I can give you much information regarding what may be going on. However, it may be a good idea for you to have a CT scan of your chest to evaluate the lung tissue a little better.

One would think your spirometry numbers would be abnormal if you had a restrictive lung tissue disease; however, I'm not sure if this is always the case.

Following up with your pulmonologist is important.

I hope you are able to find some answers soon. Keep us updated if you don't mind.

Best wishes.
 Young_Aussie - Wed Aug 22, 2007 3:15 am

Thanks for the reply Dr. Chan. The specialist told me that my lungs are in great shape, so I'm going to have to start beleiving what they say even though I feel terrible.
He thinks I'm having post-nasal drip that is irritating my vocal chords and causing them to swell up and spasm so I can't breathe properly. He also thinks I have developed Chronic Hyperventilation becasue of this. I didn't realise that hyperventilation could cause so many symptoms including my chest pains and distressing chest tightness. I have nasal sprays to clear the sinuses and relaxation breathing exercises to do to hopefully get me breathing normally again and rid me of the chest pain and tightness etc. Am also being tested in case I am allergic to our cat, as he thinks this could also be a factor. I have a follow up appointment in 5 weeks, if my symptoms are still there then I suppose it will be time to look at psychological and other possible causes.
If anyone else is reading this post and having similar unexplained long-term symptoms, have a look into Chronic Hyperventilation Syndrome, it might be the cause of your troubles, or at least a factor, and it is apparently highly underdiagnosed.

Cheers
 Dr. Chan Lowe - Wed Aug 22, 2007 7:00 pm

User avatar The mechanism your doctor explained seems to be a logical possibility. If irritation of the vocal cords is suspected this can be directly evaluated by using a small rope-like camera to actually look at the vocal cords for signs of inflammation, swelling and dysfunction.

I hope this treatment works for you.

Best wishes.

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