HomeAnswersPulmonology (Asthma Doctors)asthmaI feel tightness in my chest despite taking medicines. Why?

Can the constant feeling of tightness in the chest be COPD?

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The following is an actual conversation between an iCliniq user and a doctor that has been reviewed and published as a Premium Q&A.

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Published At May 4, 2022
Reviewed AtOctober 11, 2023

Patient's Query

Hello doctor,

I am frustrated with my asthma. I am 26 years old and developed asthma two years ago. It went untreated for almost a year, then I started taking Qvar (two puffs twice a day) and moved to Symbicort. I am currently on 180/4.5 of Symbicort, two puffs twice a day. While it helped a lot, I still have near-constant chest tightness. I was worried that it might have damaged my lungs or had done remodeling, but I underwent high resolution computed tomography (HRCT), which found no abnormalities. My pulmonary function test (PFT) results are as follows: Pre-bronchodilator forced vital capcity (FVC): 6.18 L (116 % predicted), forced expiratory volume (FEV)1: 4.53 L (102 % predicted), forced expiratory flow (FEF)25: 75 3.45 L (75 % predicted), Ratio: 73 % (88 % predicted), resistance airway (RAW): 2.27 (134 % predicted), specific airway conductance (sGAW): 0.10 (38 % predicted), Post-bronchodilator forced vital capacity (FVC): 6.34 L (119 % predicted) change is of 3 %, forced expiratory volume (FEV1): 4.69 L (106 % predicted) change is of 4 %, FEF25-75: 3.79 L (83 % predicted) change is of 10 %, Ratio: 74 % (89 % predicted) change is of 1 %. I was diagnosed with mild persistent asthma. My question is, how can I have pretty much normal spirometry with normal HRCT but still have these daily annoying symptoms. Is it possible this tightness is my new normal? I am desperately trying to get back to how I was before I developed asthma. I would appreciate any suggestions. I am thinking of Montelukast and asking to switch to Trelegy. The cardiac workup was normal (Echo and ECG).

Hi,

Welcome to icliniq.com. There are two types of treatment for asthma control and relief. I would suggest you - 1. Use Levolin (Levosalbutamol) metered-dose inhaler (MDI) two to four puffs per day. 2. Take capsule AB Phylline (Acebrophylline) 100 mg twice a day. 3. Use Symbicort (Budesonide-Formoterol) three puffs twice daily. Consult your specialist doctor, discuss with them and take medicines with their consent. Also, rule out nasal problems, like, nose block. Finally, ensure that procedure of taking puff is correct. You can see demo videos online for the same.

Patient's Query

Hello doctor,

I want to know what you think of the fact that this bronchoconstriction is daily and persistent. Is this more in line with chronic obstructive pulmonary disease (COPD)?

Hi,

Welcome back to icliniq.com. For diagnosing chronic obstructive pulmonary disease (COPD), age is an essential factor, as also smoking or long time pollution history. So, therefore, the age should be more than 40 years. And also, smoking or exposure to fumes and pollution history for at least ten years. So it goes to asthma more, but the spirometer is not completely suggestive of asthma as sometimes it tells wrong results.

Same symptoms don't mean you have the same problem. Consult a doctor now!

Dr. Chandra Shekhar
Dr. Chandra Shekhar

Pulmonology (Asthma Doctors)

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