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Chest tightness and shortness of breath with normal MRI

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, and I've asked the cardiologist if he can do more tests, especially as I noticed the other day that my resting heart rate was around 52-59 on various occasions. He's agreed to give me a heart monitor tape for a 24-hour period to see what happens.

Should I push for a stress test too or is an MRI scan pretty definitive? I'm just concerned that there's something the specialists are missing here...

2 Replies

Overall the tone of this post is one of anxiety and stress. The physical pointers being the clicking jaw, often caused by night time clenching, constant headaches and tightness of the chest..

You are young, and thankfully tests are coming back negative, so perhaps the best solution may be an evening at the pub with your buddies and not be looking for medical solutions.


Ask them to take your blood gases, that could rule out carbon dioxide retention. Ask your doctor about sleep apnea, a sleep study could rule out respiratory problems when your asleep. It can't be anxiety when your asleep unless your having nightmares.Have you had any hallucinations or black spots in your vision.


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