Why do I feel sudden chest discomfort and breathlessness?

Question

Hi doctor,

I am a girl of 20. My height is 5'48'' and my weight is 165.34 pounds. Over the past week, I have been having high discomfort and pain in my right chest when I breathe. The pain radiates to the right shoulder and right arm, too. When I sneeze or blow my nose, the pain is severe. I cannot explain this as a sharp pain, but there is a high discomfort. I fear taking long breaths, and so I take short breaths. If I do some physical activity, then this starts hurting me a lot. I became so tired and I wanted to take a short nap to recover. When I climb the staircase or if I talk continuously, then I keep panting for a while or feel short of breath. I do not feel the pain when I touch. I do not remember doing any heavy physical activity as a cause for this pain. Initially, I thought this would be a gastrointestinal problem, but my bowel movements are all as usual. Actually, for the past seven months, I have been having frequent throat infections, which resulted in bronchitis every time. I suffered from wheezing too during bronchitis. I have had breathing problems when my wheezing was severe. At those times, I used to have pain in my left chest. We took a chest X-ray, which was normal. Last bronchitis appeared 15 days ago. Now, I am in homeopathic treatment because too many antibiotics made me sick. I wanted to know the reason for this sudden discomfort in my chest. Please give me some advice on the same.

Answer 1

Hi,

Welcome to icliniq.com.

As you have a history of frequent chest infections in the past, which were associated with wheezing, secretions, and fever as well, I would suggest that you consult a pulmonologist or a chest physician in person. Your symptom of chest pain, which increases on deep respiration, seems like a pleuritic pain or a neuropathic pain. So, possibilities have to be ruled out. If your physician suggests an HRCT thorax (high-resolution computed tomography), then it can rule out other abnormalities as well if the x-ray does not reveal much. As per your history, I can think of aspergillosis (allergic reaction to fungus), pleural effusion, sequelae of some disease that have been resolved, and bronchiectasis. For now, you can take some analgesics like Paracetamol to get rid of pain. The probable causes include

1. Aspergillosis.

2. Pleural effusion.

3. Sequelae of some disease that have been resolved.

4. Bronchiectasis.

Investigations to be done are chest X-ray, electrocardiogram (ECG), HRCT thorax, and complete blood count (CBC). Preventive measures are to keep away from dust.

Answer 2

Hi,

Welcome back to icliniq.com.

I completely understand that it is some bacterial infection going on, which makes you tired and causes fatigue. The reason may be the same. Usually, all your previous symptoms and what you have told me now appear to be effusion or post-infective sequelae. So, the best way to rule out or to reach a diagnosis is to get yourself examined. Do not get stressed. You are young, so the possibilities of some common diseases are higher. I wanted to know whether you had tuberculosis in the past. Symptoms of pain are going more towards post-infective bronchiectasis.

Answer 3

Hi,

Welcome back to icliniq.com.

It was a great help with the past x-ray and prescriptions (attachment removed to protect patient identity). Now, I can tell you that you are probably suffering from allergic inflammation of the bronchus, or you can say complicated bronchial asthma. The inhalers you are taking are good, and the anti-allergies are fine. Of course, Acebrophylline will help. Now, you can ask your pulmonologist regarding the chances of allergic bronchopulmonary aspergillosis. Symptoms of bronchitis, wheeze, hemoptysis, and breathlessness are suggestive of allergic bronchopulmonary aspergillosis (ABPA). Bronchiectasis, bronchial asthma, bronchitis, and chest pain are all features of the same disease. Now your chest physician may suggest you some tests like spirometry, aspergillus skin test, eosinophil count, absolute eosinophil count, serum IgE, and IgG specific for aspergillus. If these come back positive, then corticosteroid is the drug of choice. Before taking any medications, visit a pulmonologist and discuss all the possibilities. You will be better soon.