Does COPD lead to a constant feeling of chest tightness?

Question

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).

Kindly guide.

Answer 1

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 the procedure of taking a puff is correct. You can see demo videos online for the same.

I hope this helps.

Please feel free to reach out in case of further queries.

Thank you.

Answer 2

Hi,

Welcome back to icliniq.com.

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

I hope this helps.

Please feel free to reach out in case of further queries.

Thank you.