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Forum Name: Chest symptoms

Question: Recurring shortness of breath, chest pain and cracking


 Ludwig357 - Mon Jun 23, 2008 1:29 am

I am a 21 year old male who has experienced shortness of breath and chest pain on an on and off basis for almost a year. Right now, I have been feeling short of breath on and off daily. When I turn my chest, it cracks like my knuckles would. It takes about 20 minutes or so to crack again, as a kunckle would. My shortness of breath limits my abilities to speak long sentences and sing. My chest hurts occasionally in the sternum area.

I have been to the ER about a dozen times and have received a full cardiac workup including a thallium stress test, echocardiogram, and numerous EKGs - all of which were normal. I have had 3 CT scans, and several chest X-rays - all normal. My lung function tests came back that I wasn't exhaling enough air, but after I quit smoking for 4 months, they came back that I was exhaling more than expected. However, each time I took the test.. I took it twice because the first times it would indicate a very poor performance on my lungs' part. the second times got the results i just previously stated.

What worries me greatly is that I have abused a lot of drugs in the past. Although I don't anymore... about the time this started I was then snorting painkillers quite frequently. This, in retrospect, sadly, worries me greatly as now I am aware of the risk of pulmonary granulomas and such from such mindless behavior. Although my numerous tests have been clear... i still am outrageously afraid at what I might have done and that I have some disease that has slipped under the diagnostic radar.

Help. Please.
 John Kenyon, CNA - Thu Jul 10, 2008 11:08 pm

User avatar Hi Ludwig357-

It sounds like there is definitely one benign problem going on with your chest wall, and the remote possibiity of an actual lung problem as well.

The chest discomfort, pain and cracking sounds very much like Tietz' syndrome, an often chronic inflammation of the cartilege in the intercostal spaces and where the ribs join the sternum. This can be quite painful at times, and does often feel like it needs to be "cracked" like knuckles. This condition usually responds well to non-steroidal anti-inflammatory drugs such as ibuprofen.

The shortness of breath could be due to some inhibition due to the tightness and soreness of the connective tissue inflammation, or it may overlap with some lingering infiltrate material from the snorting of drugs not intended to be inhaled. I'm not certain, but would hazard a guess that this should correct itself over time, but if you haven't discussed this with any of the medical people you've been seen by, it might be a good idea, since I assume the pain medication was ground pills, which can contain talc or other inert material which can actually cause interstitial lung disease. It probably would not be severe in your case, but it's worth looking into.

In the meantime, I would try a course of NSAID therapy, prescribed by your doctor instead of over the counter, so it can be taken at effective dose levels and under direction. This may resolve the whole problem, but I would not, especially in your case, suggest self-medicating.

Hope this is helpful, and do please keep us updated.

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