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- Wed Oct 05, 2005 5:23 pm
I am a 35-year-old female in (other than this) good health. For about the last three months, I have been experiencing shortness of breath and coughing from even the most minor exertion (like walking up a flight of stairs). I also experience pain at the "top" of the inhalation on a deep breath, and have gotten in the habit of catching my breath before I get to that point to avoid the pain. The pain is located behind the breastbone, about three inches or so below my collar bone.
I have been diagnosed with acid reflux and have been on Protonix for about a month and a half. Because of the timing, I thought that the pain and other issues might be related to the reflux, but they haven't subsided even with the acid gone. I have had a normal chest x-ray and my primary care doctor didn't hear any wheezing when she listened to my lungs. She has now referred me to a pulmonary specialist and I have an appointment next week.
I'm curious as to what might cause symptoms like this but would not show up on a chest x-ray. Also, I would like to have a good dialog with the pulmonary specialist so that we can get to the bottom of what's going on. Is there anything I should think about before my appointment that might be helpful?
| Dr. Safaa Mahmoud
- Fri Jul 07, 2006 8:17 am
Pain in the chest, Shortness of breath, and cough can result from many different causes.
- Obstruction of the air passages of the nose, mouth, or throat may lead to breathing difficulty.
- They may represent a form of asthma.
- Acid reflux causes severe pain and discomfort in the chest in the morning. Others may experience a feeling like the food stuck in their throat or tightness in the throat, dry cough and shortness of breath similar to asthma.
- Stress, anxiety, and smoking can increase these symptoms. Certain foods as well are known to aggravate the condition, and you better avoid them. These include chocolate, beverages containing caffeine, fatty and fried foods, garlic and onions, spicy and tomato containing foods.
- Psychological or emotional stress and anxiety, in these cases the diagnosis is made by exclusion of other causes.
- Exertion cough and dyspnea are early symptoms of congestive heart disease however, chest infection, lung diseases, GERD and hyperacidity or esophageal motility disorders can give similar picture.
The physical examination of the chest, heart, and the upper aero-digestive tract is mandatory for proper diagnosis.
Diagnostic tests that may be performed include:
Blood tests (LDH, LDH isoenzymes, CPK, CPK isoenzymes, Troponin) to check for cardiac related problem CBC, and blood differential to check if there is infection.
Pulmonary function tests and Lung perfusion scan
X-rays of the chest
More complex tests may be required depending on the difficulty of diagnosis or the suspected cause of the chest pain.