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Forum Name: Chest symptoms

Question: difficulty breathing when inactive


 knaik2 - Thu May 15, 2008 1:08 am

Hello. I am a 24 year old male, 5’8 and 175 lbs, who has had asthma since the age of 10. The only medication I take is Albuterol. Recently, I have been having difficulty breathing at night or when I'm inactive during the day. During these episodes, my heart rate is in the mid 40's (normally in mid 50’s when active). My peak flow meter shows that my lung capacity is normal, (actually the best its been in a few years). My blood pressure is usually a little under 120/80. Specifically, it feels like it is more difficult to breathe in and out tidal volume. Quiet breathing is less frequent and more labored. I feel like I'm suffocating sometimes. Again, this only happens when I am inactive, in bed or resting on the couch. I can do 30 minutes of cardio without pain and with the usual amount of fatigue.

I have had a period of 2 weeks in the past (November 2005) where I had these episodes nightly. When I went to the doctor, he told me that that it was psychological. The problem went away on its own. Now the problem has resurfaced. School is over and I am minimally stressed. I went to a new doctor. This doctor was concerned enough about my low pulse to do an EKG and TSH test. Both were normal. She concluded that my heart rate was probably normal for me. She says that the shortness of breath might be due to inflamed muscles because of the intense cardio and weight lifting I have been doing for the past month. I have cut back on the intensity of my exercise and the episodes persist.

Is there a diagnosis that neither of these doctors have considered? Is there something that I should look out for or make my doctor more aware of?
 John Kenyon, CNA - Thu Jul 10, 2008 11:25 pm

User avatar Hello knaik2 -

Since you tolerate vigorous exercise and the problem only presents itself while you are at rest, the strongest likelihood is that it is a symptom of chronic, generalized anxiety. Respiratory anxiety is not as common as that relating to the heart, but it is probably underreported. If you had any pulmonary dysfunction you would very likely find it worsened by intense (or even mild) exertion.

The one possible caveat to this, since you have a history of asthma, is that you could have post nasal drip and/or gastric reflux, both (either singly or in combination) account for a certain percentage of asthma cases. Sitting or lying can aggravate GI reflux, whether you feel it happening or not, and lying down (sleeping) can intensify both PND and GERD.

It's just a thought, but it's worth looking into. If this isn't the case then it is very likely attributable to anxiety as GAD often intensifies during inactivity.

I hope this is helpful. Please do follow up with us.

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