Chest tightness and shortness of breath with normal x-ray and CT Scan

Sorry, this is a long post, but I'd be really grateful if anyone on here could help.

I started having chest tightness and shortness of breath about four months ago, which started off as being intermittent and gradually got to the stage where it was constant. Around the same time, there was about a 1/2 week smog episode in London (where I live).

I happened to have a check-up scheduled at my local medical centre, during which the asthma nurse said my peak flow was a bit low (I'm 31 yrs old and hit 550), so she told me to take a blue salbutamol inhaler. I did this only sporadically to begin with, but then found I was using it 4/5 times a day, sometimes without any relief.

I went back to the doctor who recommended that I see a cardiologist. He gave me an MRI scan of the heart, which came back normal, after which I was referred to a respiratory specialist. He put me on symbicort for a couple of weeks, which elevated my peak flow readings to 620/630, but I was still getting shortness of breath and chest tightness, including in the middle of the night. He ordered blood tests (which came back with a dust mite allergy and a slight deficiency in iron - although this was within normal limits) and also ordered a chest x-ray and lung ct-scan (with contrast, in case there was a blood clot). Both came back normal.

He believes that the problem is anxiety related and referred me to a psychiatrist, who I am due to meet next week, and he has mentioned the possibility of some CBT.

Also a couple of weeks ago I developed constant daily headaches that did not seem to clear with over the counter painkillers. Again went to the doctor, who referred me to a neurologist, who gave me a brain MRI. Again, came back normal, except for some sign of congestion in my sinuses (likely because of a cold I developed about a month ago). That cold has still left me with a sense of taste and smell that is not completely back to normal.

I don't know whether it is related but I also have a "clicky" jaw, which the doctor has told me is temporomandibular joint disorder. It doesn't hurt, but my jaw does click constantly when I eat.

Although the chest tightness and shortness of breath have settled since the CT scan result, they have not completely disappeared. I have been sleeping better, although yesterday I had quite bad shortness of breath in the evening and woke up two or three times at night short of breath.

I'm really not convinced that anxiety is the problem here, do you think I should go back to the respiratory specialist? Are there any more tests that he can perform?

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37 Replies

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  • Hi tirez welcome really lovely to meet you.Well the good thing is you seemed to have been thoroughly checked and the results of all are mostly great.I know that anemia can cause breathlessness whether this is the cause Im not qualified to say.Also sinus problems can give you nasty old headaches.Depression and anxiety happens to the best of us unfortunately so it might well be helpful to follow through with appts and see how it goes,its good to talk and share .I do hope you get to the bottom of it ,stay with us this is a great forum with loads of help and support and a giggle along the way.Hopefully see you soon :) Janexx

  • I have asthma and bronchiectasis, and the asthma is certainly anxiety dependent. But that doesn't mean (for me at least) that I don't have asthma when I'm not anxious. I'm surprised you have not been tried on a steroid or combined steroid/long term reliever like seretide.

    I'd say see all the specialists that are offered, but also talk again to your GP about the breathing issue, which seems from your post to be both where it all started and not properly sorted out.

  • Perhaps as you have a dust mite allergy maybe you also have food intolerances. Although I do have emphysema I find bread and other yeast containing foods make the shortness of breath worse. Just a thought. Hope you get to the bottom of it soon.

  • Hi

    With the dust mite allergy been proven and you mentioning that you are short of breath at night it might be worth giving your bed a good vac and if you do not have anti allergy pillows put them in the tumble dryer for a good 30 mins on high. There are sprays that will kill dust mites Etc but it does not come cheap. It is a fact that it is their faeces that are the main problem.

    I have RLD and my consultant asked if I suffer headaches which I do and have done for many years.

    Back in the olden days (1970's) some doctors were still treating Asthma with Valium as they believed it was a nervous condition only.

    From all the tests that you have had it does seem that the doctor has a good open mind to what conditions may be causing you your problems and worth keeping. I hope you get it sorted out soon.

    Be Well

  • I agree wit hall that has been written here.

    summary: dust mite allergy will cause you discomfort, as suggested try to put a vacuum cleaner over the mattress, I have no tuble dryer, but it seems a very good idea. They sell sheets that protect the top of the mattress against dust mite, I have such a sheet. I did use a anti dust mites spray. Mind you I have no allergy!

    Sinusitis gives you tremendous headaches. You can deal with this with over the counter medicine, ask your friendly chemist.

    The rest of your body has been scanned and OK, so you could regain some calm. Have a good visit with the psychiatrist; well he may be helpful to alleviate your fears. Take care and cool in this heat!

    Lots of drink - I use Caledonian water which doesn't scratch the thraot and is naturally carbonated (no sugar, just natural). This should help with the sinusitis too. Take care.

  • Thanks all for your replies.

    I went back to the GP on Wednesday. She basically told me that both the cardiologist and the respiratory specialist had followed procedure and there's nothing else she could really suggest. Said the only other issue could be acid reflux, so she gave me some omeprazole. I tries this a few weeks ago for about 3 days but didn't notice much difference.

    I'm a keen cyclist and regularly rise to work (about 10 miles per day), as well as weekend club rides. I went to a training camp in Mallorca for a couple of weeks in March, where we covered around 70-80 miles per day. The GP tried to reassure me by saying that people who do that kind of thing don't usually have lung issues and again went down the anxiety route.

    I really don't believe that's the cause though, and I am also very aware of how bad the air is in London (which I've been inhaling on the bike for years now), so I'm just wondering whether the pollution is giving me grief.

    I've also thought about a food intolerance, but would that be likely to give me shortness of breath that basically lasts all day? I'm going to get a test that a friend recommended anyway, as I have had bad bloating and stomach cramps after eating in the past.

    But basically, I'm a bit stumped as to what to do next. I feel very real physical symptoms but without any of the anxiety or stress that the specialists are saying is causing it. And all the while I'm thinking that the specialists are missing something or not taking me seriously, which is obviously causing me worry.

    I've written to the cardiologist again anyway, just to ask if there's any further tests he might be able to do. When I last spoke to him, he made it sound like the MRI would be definitive, but as I say, I'm at my wits end here.

    Thanks again for listening and responding.

  • Have you ever resolved this issue? I am going through exactly what you are by the sounds of it! After having shortness of breath for about a week on and off, then constantly, he said it was a bronchial infection. Two rounds of antibiotics later and an inhaler, still not resolved and I returned two weeks later. Two more rounds of antibiotics, not clear. I returned a week later again and was given a different type of inhaler. STILL nothing. He then gave me antacid pills, as he decided it could be silent reflux. He also gave me a referral for a chest x-ray and a lung specialist. My chest x-ray came back normal but I can’t get in to see the specialist for another 6 weeks. I don’t know what to do! I’m frustrated as it is very hard to get to sleep and the doctor doesn’t seem to know what it is. I feel the same as you – I really believe it is not stress or anxiety as I am not stressed about anything and have never been anxious. I have had no reason to be!

  • I'm so glad that I'm reading this. I had the same thing going on for six months ,I've been in the hospital for a week I've had a heart cath done ,I've had a full work up on my heart and every lung test you can have . but they're saying nothings wrong . I'm 49 years old I have an eight-year-old son I cannot take groceries out of the car without being short of breath I can't check the mail without shortness of breath I sleep sitting up . but yet they have me on inhalers . Something is wrong ! I had a horse accident in 2015 I strongly believe it's scar tissue you around my rib cage and chest cavity wall they will not scope me to see that. I think I'm going to go to a university hospital

  • Dude, I have this same thing.   Going on since April of last year.   Some days are better than others but it is persistent.   Been to 2 Internal Med doctors, 2 pulmonary doctors, chest xrays (heart and lungs) and full battery of pulmonary function tests.   All say normal!   I play basketball weekly for hours and lift weights about 4 days a week.   in good shape but feel like my lungs only inflate fully about 1 out of ten deep breaths.

    I have tried acid reflux meds, breathing techniques, blah blah blah.   Doctors tell me to "go enjoy my life."   Lol, I am a 35 year old married guy with a 6 year old son and am happy.   I do have stress but I always have and this feels physical.   I think maybe it could be a Hiatal Hernia (http://www.webmd.com/digestive-disorders/hiatal-hernia) possibly because that is exactly the area it feels like something is "blocking" my lungs from opening fully.   Possibly an enlarged liver?   But I swear something is blocking my breathing.   Not exhaling - that is easy but getting a satisfactory breath in is damn near impossible.   Doesn't bother me sleeping but it is affecting my quality of life.   I feel like I am freaking suffocating sometimes.   

    Please if anyone figures this out, come back and report to us.   Never leave a fellow behind.   It is crazy so many people report this issue but nobody comes back to say what the outcome was.

    I will certainly post if I get to the bottom of it.   Thinking about going to the ER and just tell them I can't breath and let them go to town.

    C HUNTER

  • I am the same as all the above, and really at my wits end. I have a fantastic gp, but I get wheezing at night, and short of breath nearly all day. I'm fatigued to sleeping 14-18 hours a day making it difficult to do near anything, and I've had chest pain since December (now 4 months), i randomly pass out and vomit. I'm getting so over it, and so tired, that it's making me depressed and anxious. If one more person says it's a panic attack, I would like to hit them with something - panic attacks are short duration. This lasts hours, most days. I don't have any other classic panic attack symptoms. I'm literally at my wits end.

  • Don't give up.   This is hard but never give up.   I thought maybe a hiatal hernia could be it?   webmd.com/digestive-disorde...   Not sure.   Something is causing this in us...   I can barely believe how many of us there are.

  • Panic attacks can last all day. I used to have them. How many people in here have general anxiety disorder I wonder. After two years of research and this coming and going some, I believe that if we have all had blood work, pulmonary function tests, chest x-rays, heart checked and iron levels and red blood cell counts are normal and asthma is ruled out, it has to be one of two things - anxiety (which I didn't think it was for me but now I believe it) or posture / breathing incorrectly because we have slouched for years or breathed shallow for years and become less able to breath the way we could before. If all these other things have been ruled out and we are not dying, I believe it must be one of these.

  • Hey y'all!

    I'm going through the same thing but it just started about a week ago.. Last week I noticed I had two mild stomach aches accompanied by some heartburn.. ever since then I've had lots of heartburn. I'm not sure what's causing the heartburn since there hasn't been a change in my diet. I started having mild chest pain in my right and left side of my chest.. a few days ago I felt out of breath.. simple task would cause me being out of breath.

    I saw my primary doctor and he thinks my chest pain is from carrying my two yr old son.. I told him to send me to cardiologist just to be on the safe side. I'm now waiting for the referral authorization. But this morning I was drinking to work and felt shortness of breath and tight chest. I drive myself to the ER... they did all blood test, EKG, and chest/lung X-ray and they said everything came normal! They told me to follow up with my doctor..

    I'm still worried because I'm still having random chest pain here and there, even though the shortness of breath seems to be "ok" right now. The ER doctor did tell me to tell my doctor to send me to a lung specialist just in case.

    At this point it's a waiting game and not feeling good does affect my anxiety.

    I was seeing an acupuncturist of the brain and everything else and it was helping me tremendously with other issues I was having.. I stopped seeing her for about a month and all this other problems started... ugh! We'll see what happens. I'll make sure to post anything they find.

  • Hey man I've been feeling the same way for the past week, it's definately frightening as I don't know what it is or how to make it go away. Some one HELP ASAP 😩😩😩

  • I know buddy.   This super sucks.   

    I am starting to think it is something pushing up on the bottom of the diaphram possibly - just not sure what.   Feels like something is physically blocking air from going somewhere it used to.

  • It is not anxiety not is it a blood gas thing for me.   I can exhale perfectly well but a proper inhaling seems to only occur about 1 in time attempts.   Then it starts over again.   Some days are better than others.   It feels like a physical / mechanical issue in my very center like around my solar-plexus but in the center.   If that is where the diaphragm  is under the lungs, I think something is interfering with it's job in aiding the lungs to breathe.

  • If you eat does your breathing get worse if you drink does your breathing get worse mine does was wondering how yours is.

  • Mine kind of went away for awhile after persisting for about 1 year. I thought I was very ill or something but I find that it just kind of comes and goes. Dr's say it is a change in the way my body handles stress. It is the worse when I am hungover!~ But oxygen levels are good. I can play basketball and run and they say if I really had a SOB problem I would not be able to do that.

  • Just making the bed is a task for me . I've been dealing with this for 6 months and I'm just about over it with no answers .

  • I'm 49 healthy active woman horse rider never had this issue before

  • My oxygen levels are good, my chest x-rays were clear, pulmonary function tests said that I could blow 150% of the normal strength, doctor said I had one of the biggest airways he'd ever seen, heart checked out good, iron was actually high (a possible cause?) chiropractor was of no use to me, red blood count is good. How many people in here have general anxiety disorder I wonder? I do. Used to have panic attacks but now do not.

    After two years of research and this coming and going some, I believe that if we have all had blood work, pulmonary function tests, chest x-rays, heart checked and iron levels and red blood cell counts are normal and asthma is ruled out, it has to be one of two things - anxiety or a new way our body reacts to stress as we age or posture / breathing incorrectly because we have slouched for years or breathed shallow for years and become less able to breath the way we could before. If all these other things have been ruled out and we are not dying, I believe it must be one of these. I didn't believe the doctors when they said anxiety / stress because I can feel it is a physical problem. But now 2 years in I believe that is what it is. And when I would worry about the breathing thing and what could be so wrong with me, it was a self-fulfilling prophecy causing me to stress hard and thus be unable to breathe even more!!!! A snowball rolling downhill. I hardly am doing it now but it's because I have been distracted and not thinking about it at all. Hard to do - it just happened though on it's own after I had worn myself out for 2 years worrying about it daily. I eventually realized I was not going to die or I would have already and it subsided. Now I only do it when I think about it.

    I wore a CPAP face mask for snoring and the first night it felt like I was literally going to suffocate even though I was getting plenty of air. Claustrophobia must feel this way too. I believe it is like that - we FEEL as though we are unable to breathe. But in reality, if our oxygen levels are normal, we ARE able to breathe and so it must be in the mind - a perception, not a physical blockage like we feel like it is. I hope that makes some sense to someone. I know how desperate I was feeling - I lost my interest in life almost because I was miserable and felt like my life was over.

    But now I am back to normal. It took me doing all the tests I mentioned above and seeing so many doctors to rule out a true physical issue. It was hard for them to convince me but once I decided on my own that if there was really something wrong with me it would have killed me already, I decided it must be an issue of my perception. Some months after that, it kind of just went away.

  • And if it makes anyone feel better, I had been thinking I was going to die every day for like 1.5 years and now I am ok. So even if the outlook appears bleak and hopeless, don't lose hope because it can go away. For me it was just learning to stop worrying. I have ADD, OCD, and worry alot about people I love all the time so I truly think it just a new reaction to stress and anxiety that made me stress even more so it kept happening.

  • I can relate to what you are and have experienced.

    Sometimes It is difficult to differentiate between our physiological and psychological symptoms But it's also hard for the Docs that's why so many tests, my frustration leads me to wish they would find something regardless of the severity I would rather prepare to expire feeling sane then to go on being told I'm fine and it's in my head, it's no way to live.

    I live near Philadelphia PA, USA

    I've read posts regarding the air quality there and can assure you people suffer with these issues all over the world, all my best, Mark

  • when i eat or drink water my breathing also gets worse.

  • Hi there. How's it going? Im grateful i found this forum? How is everything now? I have pretty much the same situation as the rest here. About a month ago, i had a really scary experience. Right after playing basketball, i had trouble breathing and got worse in just a few minutes. Then my hands started to get numb and were like paralyzed. I was rushed to the hospital. After all the tests, the doctor said i was dehydrated and lost a lot of potassium. I was given potassium and was told to have another bloodtest the next day. Prior to that incident, i was already having chest tightness and shortness of breath at times. A few days before that basketball game, i had a lung ct scan and thedoctor said i had acute bronchitis. I was given two types of medicine, one was Montelukas Sodium Tablet taken only before bedtime and the other was Asmeton. Two hours before the basketball game, i took Asmeton and that probably also caused the problem i had after playing. Since that scary incident, i stopped taking any medication except for ibuprofen sometimes when the chest tightness really annoys me. By the way im also 35 and now, i am still having chest issues. Like you said, it does affect the quality of my life, and sleep at times, too. Im seeing an ENT specialist next week as also advised by the doctor i last met.

  • Sleep apnea could be a possibility carbon dioxide retention can cause headaches. Perhaps a sleep study would be good. Have they taken your blood gases?

  • Tirez, how are you doing now? I have exactly what you have ... Sometime I'm afraid to go to sleep.. And don't know what to do?..

  • Do you think maybe Thyroid have something to do with it?

  • I have chest tightness every winter and all year round have been waking up in the night. Im on sybicort smart. Ive just been put onto montelukast and over the past two nights I've had a full night's sleep and today I have not needed a reliever dose. 

    Amazing!

    The nurse said I was getting enough steroids, but because I was still getting chest tightness, to try montelukast.

    Amazingly it seems to be working. It's wonderful to be able to sleep at night.

    Fingers crossed that this continues. 

    X Sue

  • The original post made me think COPD as it is renowned for causing daily morning severe headaches due to excessive CO2 levels. Also, lungs can sound clear, sats can be perfect and xrays can often look normal with this condition

  • Hi all, I found this forum by chance and maybe I can shed some light on this. I started having breathing difficulties after a lung infection caused by inhaling debris from a Bathtub remodel. Anyway I got better but breathing issues continued. I became winded easily, even from grocery shopping. This when a year before I was hiking 4 hours in a Rain Forest at 108 degrees and humidity with ease, now I have troble walking from room to room, sleeping I awake with shortness of breath as well.

    After complaining to my Dr and at my yearly Physical he gave me all te usual bloodwork that cam e back with elevated Calcium levels. That result led him to ask to do more bloodwork, I had no idea what he was testing me for. Anyway, a week later I get a call telling me the Dr wants me to come to his office, I was freaking out because that has never happened for test results.

    I went in and he told me I had a Rare Genetic Hereditary Disorder called Alpha 1 Antitrypsin Deficiency and he gave me a brief explanation and threw out words health issues like COPD, Emphysema, and cirrhosis. I was thinking to myself wth are you talking about??

    Turns out this Rare Genetic Alpha 1 Antitrypsin Deficiency is not really so rare, but most Drs do not test for it unless you have A Serious Lung Didease or Liver Disease, and often even they they never test for it. s it stands right now there are many many people out there that have this and will never know because Drs in general do not know about this. In fact there are only 75 Alpha1 Specialist in the USA and the criteria to be a Specialist in this field is to only have seen a few patients with Alpha 1.

    Alpha 1Antitrypsin is a protein your liver makes that protects your lungs and liver from disease. This protein is also kinda like the glue that holds connective tissue together and is tied to many other illnesses including Aortic Dissection.

    Your antitrypsin level should be 90-200mg, mine is at 54 which is not so good. The risk in having that low of a level is that each time I get a cold, cough, Virus it will permanently damage my lungs causing scarring. The sad truth about this diagnosis is that even if you never smoked, or even if you never drink alcohol, you can end up with lung disease or liver disease. I found out in Feb this year I have this. I had my daughter tested and she has it as well, I found out my cousin passed away from this in 2014 and was liver affected, another cousin passed away from this the same year. I am sure my Mom passed from this with an Aortic Dissection.

    You can ask your Dr to test you for this, again it is called Alpha 1 Antitrypsin Defieciency and the only reson it is considered rare is because it is Rare enough that Drs do not know about it so people are not tested unless they ask to be. Often the Dr will not test unless you say there is someone in your family that has it. This is not something that is done ever in any routine testing, many times not even with a Pulmonary Dr because they have never heard of it as well.

    There are genetic Phenotypes for this disease (Levels) I am a PISZ Level 54. I am scared to death, yet I feel extremely blessed to have the Diagnosis and know what is wrong so I can do whatever it takes to keep healthy. There is no Cure, but there is Augmentation Therapy which is when they extract the protein from donated blood and then you are given the Protein through an IV weekly. The cost is between 50,000.00-75,000.0 per year!! Yes, you are not seeing things, that is the cost, and insurance will not pay unless you are already suffering from lung or liver disease. They basically wait until you are in bad shape to approve it. Some instances you can get a Alpha Dr to fight your insurance to get you on it sooner. I myself am not a Candidate, even if I was I certainly do not have that kind of money for Therapy.

    To learn more here is a link alpha1.org/what-is-alpha1

    I also have a FB Alpha 1 Group if anyone gets tested and wants to learn how to deal with your Diagnosis through natural Remedies, to learn about symptoms, treatments Western Medicine and Natural.

    Here is a link to my page and there are several other groups in FB for this as well. Blessings to you all!!

    facebook.com/groups/1777544...

  • Hi tirez and everyone else who posted on this topic over the last two years! Agree with most of the posting as allergies can cause chest tightness and problems breathing. If all the blood work, CT scan, MRIs and tests are inconclusive and do not show a problem, consider that your thoracic spin, misalignments ad injury can potentially impact your breathing, causing shortness of breath. Arthritis, not only a condition of the elderly, but present in most athletes, could stiffen your rib cage where it would seem to be hard to breeze, but usually there would be no wheezing.

    Look at Costochonditis mayoclinic.org/diseases-con... for example. The condition has no known cause, but it inhibits normal breezing. Any impact such as an accident, can affect correct alignment, so maybe go to a specialist. As for costochondritis, which in my case was caused by a car accident, it always feels like an elephant sits on your chest and does not let you breathe properly. In my case, a supplement your body produces naturally: Glucosamine Chondroitin has helped me get rid of it. My PT told me to try it for 6 weeks, if it helps great, if not, your body might not response to it, discontinue. However, it has to be Glucosamine with Chondroitin and not MSN. Also, woman seem to have this condition more than men. Good luck and all the best!

  • Hi there I am 28 yrs old I have been struggling with this same problem for about aon the now I am miserable the feeling never leaves at moments I can manage a nice deep breathe but most of the time I am gasping for air I went to the e.r last night they did ekg, blood work, chest x-ray and all was normal also they Monitored my oxygen levels and all was 100%.. they said it could be anxiety related but offered no mess to see if it would ease up. I have an inhaler that was given to me by my pcp but that seems to make it worse.. I do have scoliosis in my upper spine I'm wondering now after reading this if this could be causing my shortness of breathe.. I have also tried steam inhalation and breathing exercises none seem to help in fact the steam makes me feel worse.. I have also tried essential oils for stress and applying vicks vapor rub to my chest, lungs, and upper lip to open me up but again all these things do not give me any relief.. this is a very scary feeling I have stopped smoking cigarettes for 5 months now I am doing a follow up with my pcp soon and hopefully we can find out what's causing this to happen.. any suggestions would be greatly appreciated..thanks, C

  • Jusy wondering how you are doing did they tell you what it could be ?

  • Iv been having shortness of breath for about a month sometimes it cames on really bad that iv been really close to calling the ambulance but it passes .. i had 4 dr visits and they gave me inhalers and meds and still i am short of breath i had a Xray done it came back clear i had blood work done and it came back clear i also had a chest MRI and it came back normal. Now i am waiting for monday to get my heart checked,i am really nervous hope everything comes out ok.

  • I have been struggling to breathe since my husband used strong cleaners in our bathroom 20 years ago. That along with being claustrophobic leaves me struggling to breathe every night. My husband also worked in asbestos for many years and I did the laundry where his clothes were covered in gray powder looking stuff. I am only 4' 8" tall so clothes were right in my face. Either way, my chest crushes every night and I often open the freezer just to breathe. I just tried to have an open MRI but had to have it stopped before completed. I could not breathe and now this has followed me 3 days were I am struggling to breathe. Long years ago, I had a broncosopy in which I was told my lungs were a bloody mess from being exposed to second hand cigarette smoke. I am a non smoker but worked in offices where employers chain smoked. I am being told possibly copd or asthma, but no help in relieving my problem and inhalers do not work. Only relief I ever had was using theofflin which is a tablet, bronocal dilator. Doctors ceased using it because of its affects on the heart. I sit here now with my chest crushing and barely able to breathe. Until it happens to you, you have no idea what we go through.

  • Welcome to the forum. Your response is to a 3 year old post. You will find more up to date posts here:

    healthunlocked.com/blf

    :)

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