Question:

Kathy, I have had exactly the same thing happen to me & it put me in the emergency room. The heart turns out to be fine.  Like with you the Albuterol helps for a little while.  Actually  according to my peak flow, I was breathing ok, but the chest pain was certainly there. My doc & I found that since one of the things that brings on asthma is stress and when you are having an asthma "attack," you are certainly under stress, it can become a very viscous cycle.  He gave me some Ativan that I can put under my tongue when the Albuertol doesn’t seem to be doing the job. And guess what–when I took the Ativan (lorazepam) sublingually, within three minutes, the chest pain had stopped and I could breath–although rather exhausted, again.    You might ask your doctor about something to act as an emergency medicine to relieve the stress if the albuterol isn’t working.  After one or two pills under the tongue, you’ll know if it helps. But be sure to get an EKG to check out the heart too. Good Luck, Bob T.

– Hide quoted text — Show quoted text – Hi All – Is a chest that aches virtually constantly ‘normal’ for asthma ? Albuterol will relieve it, but only for a couple of hours.  During a flare, the chest pain intensifies to a burning sensation and feels like I’m being squeezed in half.  Breathing is extremly difficult and a trip to the Dr/ER is required. My GP (specialist initial visit isn’t until next month) brushes off my questions – tells me I’m fine.  Of course I’m fine – I’m still breathing, but maybe the asthma diagnosis isn’t correct ? TiA Kathy R.

Response:

"Non-cardiac  chest pain can be from the muscles, connective tissue , chest wall /pleura and through messages sent to various neuro receptors within the lungs" The ribs are part of the chest wall.  As many ppl suggested they may cause the pain at their articulations ( connective tissue for the most part). I do know of patients who have broken ribs coughing, however. Arthritic related disorders affecting the pulmonary system is beyond the scope of asthma but you do have my sincere sympathy as I have seen such patients really suffer. regards Deol says… – Hide quoted text — Show quoted text -You left out joint pain from your ribs. I have a problem with my arthritis causing inflammation in the lung sack. I  also learned about the joints in your throat and asthma and as usual THE HARD WAY. I am always amazed at the variety of sensations patients experience during exacerbation of asthma and other conditions such as COPD. Hopefully your doctor examined your chest with IPPA and other diagonostic tests such as a chest x-ray. ( IPPA = Inspection,percussion,palpation and auscultation) Chest x-ray was normal.  Don’t know about the rest of that. Non-cardiac  chest pain can be from the muscles, connective tissue , chest wall /pleura and through messages sent to various neuro receptors within the lungs. Do you cough a lot and have you strained connective tissue or respiratory accessory muscles in the past? I do cough – a dry hack, sometimes a lot.  The tightness does make me use every muscle available to pull air in and force it out. A widely accepted phenomenon in COPD medicine is the concept of dynamic hyperinflation. That is during an exacerbation the patient increases their respiratory frequency and this reduces the time per breath cycle for them patient to exhale. As you know asthma and COPD are obstructive respiratory disorders and reduced expiratory time may lead to air trapping and hyperinflation of the chest cavity. A hyperinflated chest is very inefficient and the normally rounded diaphragm is flattened and the rib box bows outwards and the combined effect is a very inefficient respiratory pump.  This leads to shortness of breath as the "pump" cannot keep up with the demands sent to it from the brain. In COPD medicine, our goal in therapy is to bronchodilate the patient. and often ( in some centers) to slow their breathing down and thus increases the potential expiratory time to allow the chest to "deflate"  The methods used to slow their respirations down are variable, controversial and beyond the scope of this discussion. When patients are hyperinflated, they often describe sensations such as you mentioned and I am unsure of the exact physiology, although theories are plentiful. I find that when my chest gets tight and I’m not paying attention to my breathing (ie: working, sleeping), my breathing does get shallow and probably quicker – although not panting.  When I notice this happening, I cannot take a deep breath – probably because of the trapped air from not exhaling completly.  So I take the time to force a complete exhale – using as many accessory muscles as necessary and continue to take slower deep breaths.  A dose of albuterol makes this much easier and allows regular deep breathing automatic again.  The first few times this occured, anxiety played a big roll, but I’ve become more used to it now and get it under control sooner. In asthma and occasionally COPD , we often see further problems from mucus plugging which can be severe. This also may affect the "pump" The real clincher is that anxiety often accompanies an exacerbation and this further drives up the respiratory rate and increases air trapping. Although I am a strong advocate of evidence-based medicine and in no way endorse buteyko, I think that this belief may have a basis in reducing hyperinflation/anxiety through slowed controlled breathing. I know patients who use Yoga breathing techniques to reduce anxiety and slow their breathing to good effect. It should be noted however this is a manual "reliever" and does not from my observations or evidence from the literature treat inflammation. These patients still administer rescue medications and follow a strict protocol action plan. There was little clarity in this post, I am afraid Sorry, I don’t really understand it all myself.  My asthma diagnosis was made 2 months ago and I am trying to understand all this.  Thanks very much for this information. Think about your symptoms and relate them with someone who can answer your questions face to face. Deol says… Hi All – Is a chest that aches virtually constantly ‘normal’ for asthma ? Albuterol will relieve it, but only for a couple of hours.  During a flare, the chest pain intensifies to a burning sensation and feels like I’m being squeezed in half.  Breathing is extremly difficult and a trip to the Dr/ER is required. My GP (specialist initial visit isn’t until next month) brushes off my questions – tells me I’m fine.  Of course I’m fine – I’m still breathing, but maybe the asthma diagnosis isn’t correct ? TiA Kathy R.

Response:

I have had severe chronic chest pain for about a year which is worst when I have just had a severe asthma attack. My hospital consultants have diagnosed everything from pleurisy to blood clots but the most likely explanation is from my GP who has suggested that it may be Tetse’s Syndrome. Basically this is when the cartilage at the end of the ribs becomes rough due to over working when the asthma is badly controlled, so when you breathe it ‘grates’ against the nerve endings in your chest.  Apparently the best treatment is non-steroidal anti-inflammatory drugs although unfortunately I, and many other asthmatics, am allergic to them. Obviously your chest pain may have a different cause but if the end of your ribs hurt when you press on them this diagnosis may be worth discussing with your Dr. Hope this helps. Regards, Lucy

Response:

Thanks for the info. Kathy R.

– Hide quoted text — Show quoted text – I have had severe chronic chest pain for about a year which is worst when I have just had a severe asthma attack. My hospital consultants have diagnosed everything from pleurisy to blood clots but the most likely explanation is from my GP who has suggested that it may be Tetse’s Syndrome. Basically this is when the cartilage at the end of the ribs becomes rough due to over working when the asthma is badly controlled, so when you breathe it ‘grates’ against the nerve endings in your chest.  Apparently the best treatment is non-steroidal anti-inflammatory drugs although unfortunately I, and many other asthmatics, am allergic to them. Obviously your chest pain may have a different cause but if the end of your ribs hurt when you press on them this diagnosis may be worth discussing with your Dr. Hope this helps. Regards, Lucy

Response:

When that happens to me, I often find a 2nd capsule of Theo24 (i.e., 12 hours after the first one in the evening) will stop it.  Takes about an hour to work  Also sometimes Benadryl works, and when I’m taking atropine for another purpose, I find I don’t get it at all.  And then other sometimes, if I look for an irritant I’ll find a hidden trigger—such as a newly printed color magazine or newspaper, which can be put in a plastic bag.  So, you may find a variety of solutions to try. http://community.webtv.net/CARRYNATION/ChristmasPoetry

Response:

You left out joint pain from your ribs. I have a problem with my arthritis causing inflammation in the lung sack. I  also learned about the joints in your throat and asthma and as usual THE HARD WAY.

– Hide quoted text — Show quoted text – I am always amazed at the variety of sensations patients experience during exacerbation of asthma and other conditions such as COPD. Hopefully your doctor examined your chest with IPPA and other diagonostic tests such as a chest x-ray. ( IPPA = Inspection,percussion,palpation and auscultation) Chest x-ray was normal.  Don’t know about the rest of that. Non-cardiac  chest pain can be from the muscles, connective tissue , chest wall /pleura and through messages sent to various neuro receptors within the lungs. Do you cough a lot and have you strained connective tissue or respiratory accessory muscles in the past? I do cough – a dry hack, sometimes a lot.  The tightness does make me use every muscle available to pull air in and force it out. A widely accepted phenomenon in COPD medicine is the concept of dynamic hyperinflation. That is during an exacerbation the patient increases their respiratory frequency and this reduces the time per breath cycle for them patient to exhale. As you know asthma and COPD are obstructive respiratory disorders and reduced expiratory time may lead to air trapping and hyperinflation of the chest cavity. A hyperinflated chest is very inefficient and the normally rounded diaphragm is flattened and the rib box bows outwards and the combined effect is a very inefficient respiratory pump.  This leads to shortness of breath as the "pump" cannot keep up with the demands sent to it from the brain. In COPD medicine, our goal in therapy is to bronchodilate the patient. and often ( in some centers) to slow their breathing down and thus increases the potential expiratory time to allow the chest to "deflate"  The methods used to slow their respirations down are variable, controversial and beyond the scope of this discussion. When patients are hyperinflated, they often describe sensations such as you mentioned and I am unsure of the exact physiology, although theories are plentiful. I find that when my chest gets tight and I’m not paying attention to my breathing (ie: working, sleeping), my breathing does get shallow and probably quicker – although not panting.  When I notice this happening, I cannot take a deep breath – probably because of the trapped air from not exhaling completly.  So I take the time to force a complete exhale – using as many accessory muscles as necessary and continue to take slower deep breaths.  A dose of albuterol makes this much easier and allows regular deep breathing automatic again.  The first few times this occured, anxiety played a big roll, but I’ve become more used to it now and get it under control sooner. In asthma and occasionally COPD , we often see further problems from mucus plugging which can be severe. This also may affect the "pump" The real clincher is that anxiety often accompanies an exacerbation and this further drives up the respiratory rate and increases air trapping. Although I am a strong advocate of evidence-based medicine and in no way endorse buteyko, I think that this belief may have a basis in reducing hyperinflation/anxiety through slowed controlled breathing. I know patients who use Yoga breathing techniques to reduce anxiety and slow their breathing to good effect. It should be noted however this is a manual "reliever" and does not from my observations or evidence from the literature treat inflammation. These patients still administer rescue medications and follow a strict protocol action plan. There was little clarity in this post, I am afraid Sorry, I don’t really understand it all myself.  My asthma diagnosis was made 2 months ago and I am trying to understand all this.  Thanks very much for this information. Think about your symptoms and relate them with someone who can answer your questions face to face. Deol says… Hi All – Is a chest that aches virtually constantly ‘normal’ for asthma ? Albuterol will relieve it, but only for a couple of hours.  During a flare, the chest pain intensifies to a burning sensation and feels like I’m being squeezed in half.  Breathing is extremly difficult and a trip to the Dr/ER is required. My GP (specialist initial visit isn’t until next month) brushes off my questions – tells me I’m fine.  Of course I’m fine – I’m still breathing, but maybe the asthma diagnosis isn’t correct ? TiA Kathy R.

Response:

– Hide quoted text — Show quoted text – As I stated earlier, asthma is new to me.  My hat is off to any and all who have lived with this disease for many years.  I am still learning what asthma is, how it behaves – differently for all, it seems.  I have to keep a positive attitude mainly because I don’t want to let this disease get to me. All the information and advice from this ng helps me to understand what is happening and I greatly appreciate it.  The hurried visits to my GP when the asthma flares leaves little time for much more than basic questions and answers and my initial visit to a pulmonary (?) specialist is still 3 wks away.  The info gathered here and at indicated links has been great and I have been taking notes for that initial visit. Regards, Kathy R.  - now suffering through my first cold with still out of control asthma     I’ve been suffering with a chest cold for about a month, and   the muscles in my chest and back are killing me with all that coughing.  I’ve gotten used to having these spells over the years with asthma.  I guess kathy you have to keep a positive a Before you buy.     I have to apologize, i did’nt realize you where new to this

problem.  I developed it ten years ago when i was twenty two.. I have some good news for you, which might help.  I’ve just read that a new drug that causes few or none of the side effects commonly associated with standard steroid treatment, according to a study in today’s issue of the New England Journal of Medicine.  RhuMab-E25, an intravenous drug was shown to decrease or eliminate the need for oral or inhaled steroids in patients with moderate to severe asthma by removing the allergy-causing antibody IgE from the body’s circulation. It’s supposed to be out in the next few months, i Know i’m going to give it Before you buy.

Response:

- Hide quoted text — Show quoted text – As I stated earlier, asthma is new to me.  My hat is off to any and all who have lived with this disease for many years.  I am still learning what asthma is, how it behaves – differently for all, it seems.  I have to keep a positive attitude mainly because I don’t want to let this disease get to me. All the information and advice from this ng helps me to understand what is happening and I greatly appreciate it.  The hurried visits to my GP when the asthma flares leaves little time for much more than basic questions and answers and my initial visit to a pulmonary (?) specialist is still 3 wks away.  The info gathered here and at indicated links has been great and I have been taking notes for that initial visit. Regards, Kathy R.  - now suffering through my first cold with still out of control asthma     I’ve been suffering with a chest cold for about a month, and   the muscles in my chest and back are killing me with all that coughing.  I’ve gotten used to having these spells over the years with asthma.  I guess kathy you have to keep a positive a Before you buy.     I have to apologize, i did’nt realize you where new to this problem.  I developed it ten years ago when i was twenty two.. I have some good news for you, which might help.  I’ve just read that a new drug that causes few or none of the side effects commonly associated with standard steroid treatment, according to a study in today’s issue of the New England Journal of Medicine.  RhuMab-E25, an intravenous drug was shown to decrease or eliminate the need for oral or inhaled steroids in patients with moderate to severe asthma by removing the allergy-causing antibody IgE from the body’s circulation. It’s supposed to be out in the next few months, i Know i’m going to give it Before you buy. As I stated earlier, asthma is new to me.  My hat is off to any and all who have lived with this disease for many years.  I am still learning what asthma is, how it behaves – differently for all, it seems.  I have to keep a positive attitude mainly because I don’t want to let this disease get to me. All the information and advice from this ng helps me to understand what is happening and I greatly appreciate it.  The hurried visits to my GP when the asthma flares leaves little time for much more than basic questions and answers and my initial visit to a pulmonary (?) specialist is still 3 wks away.  The info gathered here and at indicated links has been great and I have been taking notes for that initial visit. Regards, Kathy R.  - now suffering through my first cold with still out of control asthma     I’ve been suffering with a chest cold for about a month, and   the muscles in my chest and back are killing me with all that coughing.  I’ve gotten used to having these spells over the years with asthma.  I guess kathy you have to keep a positive a Before you buy.     I have to apologize, i did’nt realize you where new to this problem.  I developed it ten years ago when i was twenty two.. I have some good news for you, which might help.  I’ve just read that a new drug that causes few or none of the side effects commonly associated with standard steroid treatment, according to a study in today’s issue of the New England Journal of Medicine.  RhuMab-E25, an intravenous drug was shown to decrease or eliminate the need for oral or inhaled steroids in patients with moderate to severe asthma by removing the allergy-causing antibody IgE from the body’s circulation. It’s supposed to be out in the next few months, i Know i’m going to give it Before you buy.

Response:

As I stated earlier, asthma is new to me.  My hat is off to any and all who have lived with this disease for many years.  I am still learning what asthma is, how it behaves – differently for all, it seems.  I have to keep a positive attitude mainly because I don’t want to let this disease get to me. All the information and advice from this ng helps me to understand what is happening and I greatly appreciate it.  The hurried visits to my GP when the asthma flares leaves little time for much more than basic questions and answers and my initial visit to a pulmonary (?) specialist is still 3 wks away.  The info gathered here and at indicated links has been great and I have been taking notes for that initial visit. Regards, Kathy R.  - now suffering through my first cold with still out of control asthma – Hide quoted text — Show quoted text –     I’ve been suffering with a chest cold for about a month, and   the muscles in my chest and back are killing me with all that coughing.  I’ve gotten used to having these spells over the years with asthma.  I guess kathy you have to keep a positive a Before you buy.

Response:

I have been very "lucky" in this department.  I have has the "chest pain"…been on the treadmill…have had advanced Nuclear Imaging studies done…at the time I was having the pain…..The answer was that it was non cardiac involved…at the time. Then I have had 3 mi’s with no chest pain….go figure it out…I guess that we are all wired differently; BOB

Response:

– Hide quoted text — Show quoted text – Guess one more reply won’t hurt.  Unless an attack is more then a few moments or so, I generally get chest pains.  I think this is a result of what Colin describes as using muscles that aren’t normally used to breathe with.  Also, the area around the lungs itself most likely suffers from the ongoing inflammation of the attack. This use to scare me to the point I thought the asthma was more of a heart related problem and not so much asthma itself.  Then I discovered it was atypical for me to experience the discomfort of chest tightness, especially when experiencing a lung infection. For me, the chest tightness is the absolute worst.  It’s very painful and makes breathing very laborous. If there is concern it may be heart related then you should by all means take the tests needed to interpret this.  I was offered but have reconciled my experiences of chest pain to be asthma related as this is the only time they occur. As a precaution, my GP ordered an EKG and $ECG$.  I assume that no news is good news on those tests as I haven’t heard anything about the results. Thank you for the input. Kathy R. Best Wishes, pam     I’ve been suffering with a chest cold for about a month, and

  the muscles in my chest and back are killing me with all that coughing.  I’ve gotten used to having these spells over the years with asthma.  I guess kathy you have to keep a positive a Before you buy.

Response:

Kevin – Thanks for the reply.  I also don’t have audible wheezing – although my GP says it’s there on the inside.

If you ask your doctor he will probably tell you that you have ‘cough variant’ asthma.  This is where the primary presenting symptom is a cough rather than a wheeze. No electrons were harmed in the posting of this message.

Response:

Hi All – Is a chest that aches virtually constantly ‘normal’ for asthma ?  Albuterol will relieve it, but only for a couple of hours.  During a flare, the chest pain intensifies to a burning sensation and feels like I’m being squeezed in half.  Breathing is extremly difficult and a trip to the Dr/ER is required. My GP (specialist initial visit isn’t until next month) brushes off my questions – tells me I’m fine.  Of course I’m fine – I’m still breathing, but maybe the asthma diagnosis isn’t correct ? TiA Kathy R.

Guess one more reply won’t hurt.  Unless an attack is more then a few moments or so, I generally get chest pains.  I think this is a result of what Colin describes as using muscles that aren’t normally used to breathe with.  Also, the area around the lungs itself most likely suffers from the ongoing inflammation of the attack.   This use to scare me to the point I thought the asthma was more of a heart related problem and not so much asthma itself.  Then I discovered it was atypical for me to experience the discomfort of chest tightness, especially when experiencing a lung infection.   If there is concern it may be heart related then you should by all means take the tests needed to interpret this.  I was offered but have reconciled my experiences of chest pain to be asthma related as this is the only time they occur. Best Wishes, pam

Response:

Guess one more reply won’t hurt.  Unless an attack is more then a few moments or so, I generally get chest pains.  I think this is a result of what Colin describes as using muscles that aren’t normally used to breathe with.  Also, the area around the lungs itself most likely suffers from the ongoing inflammation of the attack. This use to scare me to the point I thought the asthma was more of a heart related problem and not so much asthma itself.  Then I discovered it was atypical for me to experience the discomfort of chest tightness, especially when experiencing a lung infection.

For me, the chest tightness is the absolute worst.  It’s very painful and makes breathing very laborous. If there is concern it may be heart related then you should by all means take the tests needed to interpret this.  I was offered but have reconciled my experiences of chest pain to be asthma related as this is the only time they occur.

As a precaution, my GP ordered an EKG and $ECG$.  I assume that no news is good news on those tests as I haven’t heard anything about the results. Thank you for the input. Kathy R. – Hide quoted text — Show quoted text – Best Wishes, pam

Response:

Linda – Thanks!  Will do, although the specialist visit is still 3 wks away. Kathy R.

– Hide quoted text — Show quoted text – Kathy, I’ve been reading a little about acid reflux. It says it can cause coughing and pain in the chest. Just a thought. You might want to ask your specialist about this. Linda

Response:

Kevin – Thanks for the reply.  I also don’t have audible wheezing – although my GP says it’s there on the inside. Kathy R.

– Hide quoted text — Show quoted text – Well I have asthma, and I get lots of chest pain, burning, cramps,etc… during flare ups (never wheezing).  I guess just another wonderful manifestation of this disease  :) -Kevin

Response:

AB- Thanks for the reply. Kathy R.

– Hide quoted text — Show quoted text – Kathy I have the same problem. I don’t have it all the time, but when I get flare ups or am having a hard day, I get the chest pain too. I don’t know if it is normal, mine has never called for a trip to the ER, but it isn’t harmful that I am aware of. HTH!!! -AB- — You can’t change the laws of physics just because they’re inconvient!! Before you buy.

Response:

Kathy, I’ve been reading a little about acid reflux. It says it can cause coughing and pain in the chest. Just a thought. You might want to ask your specialist about this. Linda – Hide quoted text — Show quoted text – I am always amazed at the variety of sensations patients experience during exacerbation of asthma and other conditions such as COPD. Hopefully your doctor examined your chest with IPPA and other diagonostic tests such as a chest x-ray. ( IPPA = Inspection,percussion,palpation and auscultation) Chest x-ray was normal.  Don’t know about the rest of that. Non-cardiac  chest pain can be from the muscles, connective tissue , chest wall /pleura and through messages sent to various neuro receptors within the lungs. Do you cough a lot and have you strained connective tissue or respiratory accessory muscles in the past? I do cough – a dry hack, sometimes a lot.  The tightness does make me use every muscle available to pull air in and force it out. A widely accepted phenomenon in COPD medicine is the concept of dynamic hyperinflation. That is during an exacerbation the patient increases their respiratory frequency and this reduces the time per breath cycle for them patient to exhale. As you know asthma and COPD are obstructive respiratory disorders and reduced expiratory time may lead to air trapping and hyperinflation of the chest cavity. A hyperinflated chest is very inefficient and the normally rounded diaphragm is flattened and the rib box bows outwards and the combined effect is a very inefficient respiratory pump.  This leads to shortness of breath as the "pump" cannot keep up with the demands sent to it from the brain. In COPD medicine, our goal in therapy is to bronchodilate the patient. and often ( in some centers) to slow their breathing down and thus increases the potential expiratory time to allow the chest to "deflate"  The methods used to slow their respirations down are variable, controversial and beyond the scope of this discussion. When patients are hyperinflated, they often describe sensations such as you mentioned and I am unsure of the exact physiology, although theories are plentiful. I find that when my chest gets tight and I’m not paying attention to my breathing (ie: working, sleeping), my breathing does get shallow and probably quicker – although not panting.  When I notice this happening, I cannot take a deep breath – probably because of the trapped air from not exhaling completly.  So I take the time to force a complete exhale – using as many accessory muscles as necessary and continue to take slower deep breaths.  A dose of albuterol makes this much easier and allows regular deep breathing automatic again.  The first few times this occured, anxiety played a big roll, but I’ve become more used to it now and get it under control sooner. In asthma and occasionally COPD , we often see further problems from mucus plugging which can be severe. This also may affect the "pump" The real clincher is that anxiety often accompanies an exacerbation and this further drives up the respiratory rate and increases air trapping. Although I am a strong advocate of evidence-based medicine and in no way endorse buteyko, I think that this belief may have a basis in reducing hyperinflation/anxiety through slowed controlled breathing. I know patients who use Yoga breathing techniques to reduce anxiety and slow their breathing to good effect. It should be noted however this is a manual "reliever" and does not from my observations or evidence from the literature treat inflammation. These patients still administer rescue medications and follow a strict protocol action plan. There was little clarity in this post, I am afraid Sorry, I don’t really understand it all myself.  My asthma diagnosis was made 2 months ago and I am trying to understand all this.  Thanks very much for this information. Think about your symptoms and relate them with someone who can answer your questions face to face. Deol says… Hi All – Is a chest that aches virtually constantly ‘normal’ for asthma ? Albuterol will relieve it, but only for a couple of hours.  During a flare, the chest pain intensifies to a burning sensation and feels like I’m being squeezed in half.  Breathing is extremly difficult and a trip to the Dr/ER is required. My GP (specialist initial visit isn’t until next month) brushes off my questions – tells me I’m fine.  Of course I’m fine – I’m still breathing, but maybe the asthma diagnosis isn’t correct ? TiA Kathy R.

Response:

Colin – Thanks for the info.  Definately looking forward to control! Kathy R.

– Hide quoted text — Show quoted text – The most likely cause is sore muscles caused by the use of ‘accessory’ muscles to assist your breathing.  Since these muscles are not designed to do this, they become sore. This is something that should go away once your asthma is brought under control. No electrons were harmed in the posting of this message.

Response:

I am always amazed at the variety of sensations patients experience during exacerbation of asthma and other conditions such as COPD. Hopefully your doctor examined your chest with IPPA and other diagonostic tests such as a chest x-ray. ( IPPA = Inspection,percussion,palpation and auscultation)

Chest x-ray was normal.  Don’t know about the rest of that. Non-cardiac  chest pain can be from the muscles, connective tissue , chest wall /pleura and through messages sent to various neuro receptors within the lungs. Do you cough a lot and have you strained connective tissue or respiratory accessory muscles in the past?

I do cough – a dry hack, sometimes a lot.  The tightness does make me use every muscle available to pull air in and force it out. – Hide quoted text — Show quoted text – A widely accepted phenomenon in COPD medicine is the concept of dynamic hyperinflation. That is during an exacerbation the patient increases their respiratory frequency and this reduces the time per breath cycle for them patient to exhale. As you know asthma and COPD are obstructive respiratory disorders and reduced expiratory time may lead to air trapping and hyperinflation of the chest cavity. A hyperinflated chest is very inefficient and the normally rounded diaphragm is flattened and the rib box bows outwards and the combined effect is a very inefficient respiratory pump.  This leads to shortness of breath as the "pump" cannot keep up with the demands sent to it from the brain. In COPD medicine, our goal in therapy is to bronchodilate the patient. and often ( in some centers) to slow their breathing down and thus increases the potential expiratory time to allow the chest to "deflate"  The methods used to slow their respirations down are variable, controversial and beyond the scope of this discussion. When patients are hyperinflated, they often describe sensations such as you mentioned and I am unsure of the exact physiology, although theories are plentiful.

I find that when my chest gets tight and I’m not paying attention to my breathing (ie: working, sleeping), my breathing does get shallow and probably quicker – although not panting.  When I notice this happening, I cannot take a deep breath – probably because of the trapped air from not exhaling completly.  So I take the time to force a complete exhale – using as many accessory muscles as necessary and continue to take slower deep breaths.  A dose of albuterol makes this much easier and allows regular deep breathing automatic again.  The first few times this occured, anxiety played a big roll, but I’ve become more used to it now and get it under control sooner. – Hide quoted text — Show quoted text – In asthma and occasionally COPD , we often see further problems from mucus plugging which can be severe. This also may affect the "pump" The real clincher is that anxiety often accompanies an exacerbation and this further drives up the respiratory rate and increases air trapping. Although I am a strong advocate of evidence-based medicine and in no way endorse buteyko, I think that this belief may have a basis in reducing hyperinflation/anxiety through slowed controlled breathing. I know patients who use Yoga breathing techniques to reduce anxiety and slow their breathing to good effect. It should be noted however this is a manual "reliever" and does not from my observations or evidence from the literature treat inflammation. These patients still administer rescue medications and follow a strict protocol action plan. There was little clarity in this post, I am afraid

Sorry, I don’t really understand it all myself.  My asthma diagnosis was made 2 months ago and I am trying to understand all this.  Thanks very much for this information. – Hide quoted text — Show quoted text – Think about your symptoms and relate them with someone who can answer your questions face to face. Deol

– Hide quoted text — Show quoted text – says… Hi All – Is a chest that aches virtually constantly ‘normal’ for asthma ? Albuterol will relieve it, but only for a couple of hours.  During a flare, the chest pain intensifies to a burning sensation and feels like I’m being squeezed in half.  Breathing is extremly difficult and a trip to the Dr/ER is required. My GP (specialist initial visit isn’t until next month) brushes off my questions – tells me I’m fine.  Of course I’m fine – I’m still breathing, but maybe the asthma diagnosis isn’t correct ? TiA Kathy R.

Response:

Well I have asthma, and I get lots of chest pain, burning, cramps,etc… during flare ups (never wheezing).  I guess just another wonderful manifestation of this disease  :) -Kevin

– Hide quoted text — Show quoted text – Hi All – Is a chest that aches virtually constantly ‘normal’ for asthma ? Albuterol will relieve it, but only for a couple of hours.  During a flare, the chest pain intensifies to a burning sensation and feels like I’m being squeezed in half.  Breathing is extremly difficult and a trip to the Dr/ER is required. My GP (specialist initial visit isn’t until next month) brushes off my questions – tells me I’m fine.  Of course I’m fine – I’m still breathing, but maybe the asthma diagnosis isn’t correct ? TiA Kathy R.

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I am always amazed at the variety of sensations patients experience during exacerbation of asthma and other conditions such as COPD. Hopefully your doctor examined your chest with IPPA and other diagonostic tests such as a chest x-ray. ( IPPA = Inspection,percussion,palpation and auscultation) Non-cardiac  chest pain can be from the muscles, connective tissue , chest wall /pleura and through messages sent to various neuro receptors within the lungs. Do you cough a lot and have you strained connective tissue or respiratory accessory muscles in the past? A widely accepted phenomenon in COPD medicine is the concept of dynamic hyperinflation. That is during an exacerbation the patient increases their respiratory frequency and this reduces the time per breath cycle for them patient to exhale. As you know asthma and COPD are obstructive respiratory disorders and reduced expiratory time may lead to air trapping and hyperinflation of the chest cavity. A hyperinflated chest is very inefficient and the normally rounded diaphragm is flattened and the rib box bows outwards and the combined effect is a very inefficient respiratory pump.  This leads to shortness of breath as the "pump" cannot keep up with the demands sent to it from the brain. In COPD medicine, our goal in therapy is to bronchodilate the patient. and often ( in some centers) to slow their breathing down and thus increases the potential expiratory time to allow the chest to "deflate"  The methods used to slow their respirations down are variable, controversial and beyond the scope of this discussion. When patients are hyperinflated, they often describe sensations such as you mentioned and I am unsure of the exact physiology, although theories are plentiful. In asthma and occasionally COPD , we often see further problems from mucus plugging which can be severe. This also may affect the "pump" The real clincher is that anxiety often accompanies an exacerbation and this further drives up the respiratory rate and increases air trapping. Although I am a strong advocate of evidence-based medicine and in no way endorse buteyko, I think that this belief may have a basis in reducing hyperinflation/anxiety through slowed controlled breathing. I know patients who use Yoga breathing techniques to reduce anxiety and slow their breathing to good effect. It should be noted however this is a manual "reliever" and does not from my observations or evidence from the literature treat inflammation. These patients still administer rescue medications and follow a strict protocol action plan. There was little clarity in this post, I am afraid Think about your symptoms and relate them with someone who can answer your questions face to face. Deol says… – Hide quoted text — Show quoted text -Hi All – Is a chest that aches virtually constantly ‘normal’ for asthma ?  Albuterol will relieve it, but only for a couple of hours.  During a flare, the chest pain intensifies to a burning sensation and feels like I’m being squeezed in half.  Breathing is extremly difficult and a trip to the Dr/ER is required. My GP (specialist initial visit isn’t until next month) brushes off my questions – tells me I’m fine.  Of course I’m fine – I’m still breathing, but maybe the asthma diagnosis isn’t correct ? TiA Kathy R.

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Hi All – Is a chest that aches virtually constantly ‘normal’ for asthma ?  Albuterol will relieve it, but only for a couple of hours.  During a flare, the chest pain intensifies to a burning sensation and feels like I’m being squeezed in half.  Breathing is extremly difficult and a trip to the Dr/ER is required. My GP (specialist initial visit isn’t until next month) brushes off my questions – tells me I’m fine.  Of course I’m fine – I’m still breathing, but maybe the asthma diagnosis isn’t correct ? TiA Kathy R.

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Hi All – Is a chest that aches virtually constantly ‘normal’ for asthma ?  Albuterol will relieve it, but only for a couple of hours.  During a flare, the chest pain intensifies to a burning sensation and feels like I’m being squeezed in half.  Breathing is extremly difficult and a trip to the Dr/ER is required. My GP (specialist initial visit isn’t until next month) brushes off my questions – tells me I’m fine.  Of course I’m fine – I’m still breathing, but maybe the asthma diagnosis isn’t correct ?

The most likely cause is sore muscles caused by the use of ‘accessory’ muscles to assist your breathing.  Since these muscles are not designed to do this, they become sore. This is something that should go away once your asthma is brought under control. No electrons were harmed in the posting of this message.

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– Hide quoted text — Show quoted text – Hi All – Is a chest that aches virtually constantly ‘normal’ for asthma ? Albuterol will relieve it, but only for a couple of hours.  During a flare, the chest pain intensifies to a burning sensation and feels like I’m being squeezed in half.  Breathing is extremly difficult and a trip to the Dr/ER is required. My GP (specialist initial visit isn’t until next month) brushes off my questions – tells me I’m fine.  Of course I’m fine – I’m still breathing, but maybe the asthma diagnosis isn’t correct ? TiA Kathy R.

Kathy I have the same problem. I don’t have it all the time, but when I get flare ups or am having a hard day, I get the chest pain too. I don’t know if it is normal, mine has never called for a trip to the ER, but it isn’t harmful that I am aware of. HTH!!! -AB- — You can’t change the laws of physics just because they’re inconvient!! Before you buy.

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