Q. I get sudden shortness of breath with wheezing and sharp pain. Could it be COPD or PF?

Answered by
Dr. Parth R Goswami
and medically reviewed by Dr. Vinodhini. J
This is a premium question & answer published on Mar 19, 2020 and last reviewed on: Mar 27, 2020

Hello doctor,

I am a 24-year-old female. I am 185 lbs and 5 feet inches in height. I have never had allergies or asthma. About six months ago, I started having shortness of breath, wheezing and the feeling that my air was not catching. I have sudden sharp pains that feel like something wanting to burst when I breathe in that double me over.

I immediately quit smoking cold turkey and drinking energy drinks. I used to be a pack and a half a day smoker and drink about three energy drinks a day since 15. The ER diagnosed me with a panic attack which I knew was wrong as I was no breathless from panic I was panicked from breathlessness. I then made an appointment and the doctor heard the wheezing and diagnosed me with walking pneumonia. She gave me antibiotics and Albuterol which did nothing. My sputum test came back normal even though it is black and brown gelatinous and sticky. And so I did my two chest x-rays. We have no pulmonologists or respiratory therapists in my town. I made another appointment and asked my doctor about Chlamydial pneumonia (not the STD). Turns out he was a physician assistant, had to google what it was and then gave me Hydroxicycline mono and more Albuterol which I am currently on. Still no relief at all.

I am worried I have PF or COPD and have had a miscarriage from coughing and so depressed for the last six months because I cannot think or focus on anything. I constantly feel like I am just catching my breath like the edges of my lungs are not getting any oxygen. It is noticeable when I try to have a conversation, eat or drink, or do anything. It is ruining my life but what it is and I do not know what tests to ask for. I am terrified of having chronic adult-onset asthma or other COPD or something irreversible. I am worried that even if it was reversible, to begin with after six months of being put on my clinics merry go round with no diagnosis it is probably irreversible now. Which I try not to think. What does this sound like? What are the chances it is a curable issue? What tests should I ask for? Could the energy drinks have caused heart damage? Please help.



Welcome to the

Before labeling dyspnea from a panic attack (psychological cause), all organic causes need to be ruled out. Your chest x-ray (attachment removed to protect patient identity) and sputum examination are normal, hence, infective etiology is less likely.

To rule out any organic cause your work up needed as follows:

1. Auscultation for rhonchi if heard.

2. CBC (complete blood count).

3. Pulmonary function test. (If you have asthma or COPD then PFT will rule out it).

4. EKG for cardiac evaluation.

5. And finally, your calf should be examined. If calf swollen with inflammation is present then D dimer done.

From these investigations your diagnosis will be clear. If no organic cause found then panic attack can be considered as etiology for your condition.

For doing PFT pulmonologist is needed. So try to make a visit to nearby pulmonologist in another city for examination and doing PFT.

If panic attack is the diagnosis (after rule out other causes by the above investigations) then yoga, meditation are beneficial and suitable medication will be started by the psychiatrist.

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