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Dr. Andrew Rynne

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What causes chest tightness and shortness of breath when I speak loudly?

Answered by
Dr.
Dr. Kaushal Bhavsar

Pulmonologist

Practicing since :2008

Answered : 14576 Questions

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Posted on Sat, 10 Sep 2016 in Lung and Chest disorders
Question: Hello,

I have a question regarding my breathing patterns. I am a basketball coach, and when I speak loudly and heavily for a certain period of time, I get chest tightness, shortness of breath, heavy tightness in my diafram, and eventually break into heart palpitations. I have had all types of heart workups done over the past 6 years, short of anything invasive and the only thing they have found is atrial tachycardia, but do not have a full explanation why it happens. Stress tests have been negative, 3D echoes have been cleared, and all other tests showed only the atrial tachycardia. The next thing my doctor says may be the only thing going on could be pulmonary issues. He doubts there is anything wrong with me, but I have not been able to play basketball, speak loudly for a long time, or really exert much energy without heavy shortness of breath. Could you point me towards what I could be looking at pulmonary wise if anything. This all started about 10 years against when I started doing mold removal wearing HEPA filtered masks. I was never fit for a mask, and I'm not sure if that could affect my breathing, but I would appreciate some guidance. Thank you!

XXXX
doctor
Answered by Dr. Kaushal Bhavsar 5 hours later
Brief Answer:
Better to get done PFT.

Detailed Answer:
Thanks for your question on Healthcare Magic.
I can understand your concern.
No need to worry for heart diseases as your extensive cardiac work up is normal.
By your history and description, possibility of laryngeal muscle related diseases or vocal cord related diseases or stress related diseases is more.
Your symptoms are associated with loud and prolonged speaking. Usually lung related diseases give symptoms on exertion. So lung related diseases is less likely.
But better to get done PFT (Pulmonary Function Test) to rule out lung pathology.
If PFT is normal then no need to worry for lung related diseases.
Hope I have solved your query. I will be happy to help you further. Wish you good health. Thanks.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Kaushal Bhavsar 11 minutes later
Thank uou for your answer. I will set up the test you have recommended. As for exertion, i cannot work out or even walk for lomg periods of time without neck and check tightness. What do you suppose that is related to if not my heart?

Thanks,

XXXXX
doctor
Answered by Dr. Kaushal Bhavsar 16 minutes later
Brief Answer:
Possibility of laryngeal muscle or vocal cord or stress related diseases mo

Detailed Answer:
Thanks for your follow up question on Healthcare Magic.
I can understand your concern.
Possibility of lung related diseases is also very less.
By your history and description possibility of
1. Laryngeal muscle related diseases
2. Vocal cord related diseases
3. Stress related
So please let me know if you are having stressful life.
I will be happy to help you further. Wish you good health. Thanks.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Kaushal Bhavsar 22 minutes later
Thank you fornthe answer. I actualy have seen a ear nose and throat doctor which said i had severe irritation of the larynx. We thought it may be due to my heavy acid reflux back in the day. Most if these issues started around the same time i had gained a lot of weight and had sever reflux to the point where it would wake me up choking and i would have to vomit in order to be able to breathe. That is around the same time i began having the heart palpitations and racing heart rate. Could the acid reflux be the reason i started the palpitations and also started having the tightness of the neck and chest? I started taking Nexium in February and my heart palpitations have happened less frequently, but i still cannot tolerate exercise without the chest tightness and the neck cramps/tightness/spasms. My stress level is under control, but it was heavy through all these things. Let me know your thiughts. Thanks!
doctor
Answered by Dr. Kaushal Bhavsar 0 minute later
Brief Answer:
Yes, acid reflux can cause similar symptoms.

Detailed Answer:
Thanks for your follow up question on Healthcare Magic.
I can understand your concern.
In my opinion you are mostly having GERD (gastroesophageal reflux disease).
And this can cause similar symptoms.
Along with nexium, you should also take levosulperide.
It is pro kinetic drug helps more with reflux disease.
Stress is also a risk factor for GERD. So stress management is also very important.
May I ask you few more questions regarding stress?
Have you ever consulted psychiatrist?
Are you taking any anxiolytic drugs?
Please reply me answers of above asked questions, so that I can guide you better. I will be happy to help you further. Wish you good health. Thanks.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Kaushal Bhavsar 31 minutes later
Thanks doctor. I have not consilted a psychiatrist as i have not been open to taking any psych meds. It seems like everytine i tell a doctor about my systems, they make it easy on themselves and tell me to take anxiety meds. Im not saying mental is not a factor, im just saying i also know my body. Let me know your thoughts please. Also, if mental is a big factor, could it just be as simole as antianxiety meds, or do we look deeper. I hate to just oit a bandaid on something that needs deeper looking into. Thanks .
doctor
Answered by Dr. Kaushal Bhavsar 1 hour later
Brief Answer:
Better to consult psychiatrist and get yourself evaluated for the same.

Detailed Answer:
Thanks for your follow up question on Healthcare Magic.
I can understand your concern.
To know this, you need to consult psychiatrist in person and discuss your symptoms.
Psychiatrist will also ask some questions and if he/she feels that you are suffering from some psychiatric disease then he/she will give you appropriate medicines and counsel you for future.
For all these you have to first meet psychiatrist and talk with him/her.
I am not saying that you are definitely having psychiatric illness. But your symptoms are more suggestive of GERD and undiagnosed, uncontrolled stress is one of the risk factor for GERD.
So better to rule out stress in your case.
Hope I have solved your query. I will be happy to help you further. Wish you good health. Thanks.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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