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Doctors Lounge - Chest Answers

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Back to Chest Answers List

Forum Name: Chest symptoms

Question: Shortness of breath - negative CT and normal PFT values


 REVJR1 - Thu May 07, 2009 11:32 am Bookmark and Share  

I'm a 38 year-old male, smoker. Three weeks ago I woke feeling short of breath, as if I couldn't get a deep, full breath down my throat - no choking or gasping, congestion, mucus, etc., just this feeling of breathlessness. Since then this symptom has been with me 24/7 and is usually worse when I lie down to sleep (I will jerk awake feeling breathless). A chest CT scan and x-ray showed no pulmonary abnormalities and the PFT values were normal. Pulse oxygen rate was 97%. I also have reflux that lately seems in sync with the shortness of breath, i.e., feeling like a pressure and acidity at the pit of my esophagus and between shoulder blades when I breathe deeply through the mouth. A cardiac work-up last year was negative for cardiac issues.

My question - is there a chance this could be an allergy, sleep apnea, or GERD-related?
If it's an allergy, is there a good OTC that could help with breathing? Doctor prescribed Claritin and Prilosec which haven't worked.

Thanks for any guidance.
 John Kenyon, CNA - Thu May 14, 2009 2:41 pm Bookmark and Share  

User avatar Hello --

There are several fairly benign possible causes of this, and sleep apnea is one possibility, but since you don't mention obesity and this is of fairly recent onset, I'm more inclined to suspect GERD-related nocturnal asthma, or possibly even an anxiety problem. If it is allergy related or asthma secondary to GERD, the most effective antihistimine is often Singulair, a unique medication that has a good record in managing allergic and other forms of asthma.

I'd mentioned anxiety as well, and you could be having nocturnal anxiety attacks or even sleep paralysis, a very strange anxiety and stress-related phenomenon that often causes the sufferer to wake suddenly gasping for breath only to stabilize in a few minutes and go back to sleep. It is a poorly understood mechanism but is benign, although it can be pretty disruptive of sleep.

I think I'd try and eliminate the GERD/asthma possibilities first, and SIngulair might well be a good thing to combine with Prilosec therapy. After that consider sleep apnea, especially if you're overweight, and anxiety/sleep paralysis variant beyond that.

Hope this is helpful. Good luck to you and please follow up with us here as needed.

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