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What Causes Unexplained Throat Tightness, Chest Heaviness And Dry Cough?
Question: Hi Doc,
May 2015 i started to experience throat symptoms below my XXXXXXX apple like someone was pressing on my throat. It is must worse if i am reclined or laying on my back. As a matter of fact, I can no longer sleep on my back because it bothers me so much.
My problem is that no one has been able to diagnose what this may be. I have had the following:
- Silent reflux treatment (no effect)
- Barium Swallow (nothing that should impact my throat)
- Endoscopy (all clear and no issues)
- Ultra Sound (slightly enlarged Thyroid, but not big enough to cause these symptoms)
- Neck CT (nothing showing in throat)
- ENT nose scope (nothing showing)
It has been suggested that this could be anxiety related (very diplomatically) ;-). I don't agree as I am not an anxious person and it would also mean that every time I reclined or laid on my back in the last year I became anxious. The other thing the ENT said that it could be muscular. Not sure how that effects it only when I recline or lay down.
It also feel like my chest is a bit heavy and it also sometimes gives me a light dry cough. I think my doctor is going to lock me away soon because I am "on him" about getting this resolved. ;-p It should be noted that I use a CPAP at night and I am probably 20lbs above my ideal weight.
I sleep with a wedge in my bed, eat healthy organic foods, rarely drink and don't do drugs. I did smoke for years but not for a long time now. I am not sure what to do next. It is very bothersome symptom wise. It does vary in severity depending on the day but like I said, does seem to radiate down into my lungs.
May 2015 i started to experience throat symptoms below my XXXXXXX apple like someone was pressing on my throat. It is must worse if i am reclined or laying on my back. As a matter of fact, I can no longer sleep on my back because it bothers me so much.
My problem is that no one has been able to diagnose what this may be. I have had the following:
- Silent reflux treatment (no effect)
- Barium Swallow (nothing that should impact my throat)
- Endoscopy (all clear and no issues)
- Ultra Sound (slightly enlarged Thyroid, but not big enough to cause these symptoms)
- Neck CT (nothing showing in throat)
- ENT nose scope (nothing showing)
It has been suggested that this could be anxiety related (very diplomatically) ;-). I don't agree as I am not an anxious person and it would also mean that every time I reclined or laid on my back in the last year I became anxious. The other thing the ENT said that it could be muscular. Not sure how that effects it only when I recline or lay down.
It also feel like my chest is a bit heavy and it also sometimes gives me a light dry cough. I think my doctor is going to lock me away soon because I am "on him" about getting this resolved. ;-p It should be noted that I use a CPAP at night and I am probably 20lbs above my ideal weight.
I sleep with a wedge in my bed, eat healthy organic foods, rarely drink and don't do drugs. I did smoke for years but not for a long time now. I am not sure what to do next. It is very bothersome symptom wise. It does vary in severity depending on the day but like I said, does seem to radiate down into my lungs.
Brief Answer:
Get done fresh sleep study.
Detailed Answer:
Thanks for your question on Healthcare Magic.
I can understand your concern.
You are mostly having sleep apnea because you are overweight and using CPAP machine at night.
Your throat symptoms especially in lying down position is mostly due to excess neck fat pad.
On lying down, this excess fat can cause pressure on wind pipe and cause all these symptoms.
So please let me know
1. Have you ever undergone sleep study?
2. What is your weight?
3. What is your height?
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.
Get done fresh sleep study.
Detailed Answer:
Thanks for your question on Healthcare Magic.
I can understand your concern.
You are mostly having sleep apnea because you are overweight and using CPAP machine at night.
Your throat symptoms especially in lying down position is mostly due to excess neck fat pad.
On lying down, this excess fat can cause pressure on wind pipe and cause all these symptoms.
So please let me know
1. Have you ever undergone sleep study?
2. What is your weight?
3. What is your height?
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
Hi. Thanks for the email.
I used the CPAP from April 2013 until July 2015. There was mention that the CPAP might have caused some issues. So I switched to a Dental Apnea device and used it from August 2015 to May 2016. There was no improvement to my throat symptoms. However, since I have gone back on the CPAP for the last couple of weeks, there are days when my throat seems worse.
My height is 5'10" or 178cm
Weight right now is my heaviest at 200 lbs. my neck is 16.5 inches. I have had three sleep studies. Diagnosed with moderate apnea.
Thanks for helping me.
I used the CPAP from April 2013 until July 2015. There was mention that the CPAP might have caused some issues. So I switched to a Dental Apnea device and used it from August 2015 to May 2016. There was no improvement to my throat symptoms. However, since I have gone back on the CPAP for the last couple of weeks, there are days when my throat seems worse.
My height is 5'10" or 178cm
Weight right now is my heaviest at 200 lbs. my neck is 16.5 inches. I have had three sleep studies. Diagnosed with moderate apnea.
Thanks for helping me.
Brief Answer:
What problems you found with CPAP use?
Detailed Answer:
Thanks for your follow up question on Healthcare Magic.
I can understand your concern.
In my opinion, your all symptoms are due to sleep apnea.
You need to wear CPAP mask during night. Along with this, you should also do weight reduction.
Please let me know
1. Do you snore in the night?
2. What problems you found with CPAP use?
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
What problems you found with CPAP use?
Detailed Answer:
Thanks for your follow up question on Healthcare Magic.
I can understand your concern.
In my opinion, your all symptoms are due to sleep apnea.
You need to wear CPAP mask during night. Along with this, you should also do weight reduction.
Please let me know
1. Do you snore in the night?
2. What problems you found with CPAP use?
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
Hi Doc,
Thank you for the response. I do wear the CPAP at night every night. I stopped last year and switched to the dental sleep apnea device because I was told the CPAP might be causing my throat issues. To recap the sleep apnea:
April 2013 to August 2015 - CPAP
August 2015 to May 2016 - Dental Sleep Apnea device XXXXXXX 2016 to present back on CPAP
I also sleep mostly on my side now.
I do not snore if I am wearing the CPAP or dental apnea device. I would snore if I didnt wear one. But I always do at night.
I do agree with you on the weight loss idea. I am sure that might help. sometimes these symptoms are so strong that they make it very hard to do anything. It starts at the throat and radiates down into my chest/lungs.
I am also wondering about two things:
1. The throat irritation is below my Adam's apple and downwards. That's where it feels tight. My worry is the feeling like it radiates down my air tube to my lungs. If it was fat would the sensations not always be the same? Right now the severity is different every day. Some days is lighter and some days I can't even focus cause it is so severe.
2. Could there be some lung involvement since the it feels that way?
Thanks again for your help. I know it must be tough to try and sort out the symptoms.
Thank you for the response. I do wear the CPAP at night every night. I stopped last year and switched to the dental sleep apnea device because I was told the CPAP might be causing my throat issues. To recap the sleep apnea:
April 2013 to August 2015 - CPAP
August 2015 to May 2016 - Dental Sleep Apnea device XXXXXXX 2016 to present back on CPAP
I also sleep mostly on my side now.
I do not snore if I am wearing the CPAP or dental apnea device. I would snore if I didnt wear one. But I always do at night.
I do agree with you on the weight loss idea. I am sure that might help. sometimes these symptoms are so strong that they make it very hard to do anything. It starts at the throat and radiates down into my chest/lungs.
I am also wondering about two things:
1. The throat irritation is below my Adam's apple and downwards. That's where it feels tight. My worry is the feeling like it radiates down my air tube to my lungs. If it was fat would the sensations not always be the same? Right now the severity is different every day. Some days is lighter and some days I can't even focus cause it is so severe.
2. Could there be some lung involvement since the it feels that way?
Thanks again for your help. I know it must be tough to try and sort out the symptoms.
Brief Answer:
Have you ever ever undergone PFT?
Detailed Answer:
Thanks for your follow up question on Healthcare Magic.
I can understand your concern.
Uncontrolled sleep apnea can cause bronchitis add other lung diseases.
So your feeling of radiation downwards can be due to bronchitis.
So please let me know
1. Have you ever undergone PFT (pulmonary function test)?
Please reply me answer of above asked question, so that I can guide you better. I will be happy to help you further. Wish you good health. Thanks.
Have you ever ever undergone PFT?
Detailed Answer:
Thanks for your follow up question on Healthcare Magic.
I can understand your concern.
Uncontrolled sleep apnea can cause bronchitis add other lung diseases.
So your feeling of radiation downwards can be due to bronchitis.
So please let me know
1. Have you ever undergone PFT (pulmonary function test)?
Please reply me answer of above asked question, 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
Hello,
Thanks for your response. No I have never had a PFT.
Thanks for your response. No I have never had a PFT.
Brief Answer:
Get done fresh sleep study and PFT.
Detailed Answer:
Thanks for your follow up question on Healthcare Magic.
I can understand your concern.
In my opinion, you should get done fresh sleep study and PFT (pulmonary function test).
PFT will not only diagnose bronchitis but it will also tell you about severity of the disease and treatment is based on severity only.
Sleep study is needed to see whether your sleep apnea is worsening or not.
Please let me know
1. Do you have breathlessness on exertion?
2. Have you ever undergone sleep study?
3. If yes then titration with CPAP was done or not?
4. Where do you work? Do you have any exposure to chemicals or pollution or Fumes?
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.
Brief Answer:
You should definitely get done PFT.
Detailed Answer:
Thanks for your follow up question on Healthcare Magic.
I can understand your concern.
Since you are having sleep apnea, chest discomfort and breathlessness only exertion, you should definitely get done PFT for the diagnosis of bronchitis.
If it shows obstructive Airway defect then you will need inhaled bronchodilator and inhaled corticosteroids.
Please let me know
1. Since how many years you are working in that house?
Please reply me answer of above asked question, so that I can guide you better. I will be happy to help you further. Wish you good health. Thanks
Get done fresh sleep study and PFT.
Detailed Answer:
Thanks for your follow up question on Healthcare Magic.
I can understand your concern.
In my opinion, you should get done fresh sleep study and PFT (pulmonary function test).
PFT will not only diagnose bronchitis but it will also tell you about severity of the disease and treatment is based on severity only.
Sleep study is needed to see whether your sleep apnea is worsening or not.
Please let me know
1. Do you have breathlessness on exertion?
2. Have you ever undergone sleep study?
3. If yes then titration with CPAP was done or not?
4. Where do you work? Do you have any exposure to chemicals or pollution or Fumes?
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.
Brief Answer:
You should definitely get done PFT.
Detailed Answer:
Thanks for your follow up question on Healthcare Magic.
I can understand your concern.
Since you are having sleep apnea, chest discomfort and breathlessness only exertion, you should definitely get done PFT for the diagnosis of bronchitis.
If it shows obstructive Airway defect then you will need inhaled bronchodilator and inhaled corticosteroids.
Please let me know
1. Since how many years you are working in that house?
Please reply me answer of above asked question, 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
Hi Doc,
Thanks. See answers below.
1. Do you have breathlessness on exertion? Yes I do.
2. Have you ever undergone sleep study? I have had three
3. If yes then titration with CPAP was done or not? One sleep study was done with the Cpap on
4. Where do you work? Do you have any exposure to chemicals or pollution or Fumes? I work from home. I did live in an old house with very dirty ventilation system. Perhaps even mold.
I hope that helps.
Thank,you doc. I only lived in that house for two years.
But every morning woke up sneezing and runny nose. I left that house last year in August. The new house has no issues and I no longer sneeze in the mornings.
Thanks. See answers below.
1. Do you have breathlessness on exertion? Yes I do.
2. Have you ever undergone sleep study? I have had three
3. If yes then titration with CPAP was done or not? One sleep study was done with the Cpap on
4. Where do you work? Do you have any exposure to chemicals or pollution or Fumes? I work from home. I did live in an old house with very dirty ventilation system. Perhaps even mold.
I hope that helps.
Thank,you doc. I only lived in that house for two years.
But every morning woke up sneezing and runny nose. I left that house last year in August. The new house has no issues and I no longer sneeze in the mornings.
Brief Answer:
May I ask you more questions?
Detailed Answer:
Thanks for your follow up question on Healthcare Magic.
I can understand your concern.
No issues if you left that dirty home.
But get done PFT to know whether you had bronchitis or not.
Honestly speaking, sleep apnea can also cause heart diseases especially if it is uncontrolled as in your case your case. And heart diseases can also cause similar symptoms.
For this I want to ask few more questions.
I know it is irritating sometimes for the patient.
Some users font like if I ask questions.
So I want your permission to ask you further questions.
I will be happy to help you further. Wish you good health. Thanks.
May I ask you more questions?
Detailed Answer:
Thanks for your follow up question on Healthcare Magic.
I can understand your concern.
No issues if you left that dirty home.
But get done PFT to know whether you had bronchitis or not.
Honestly speaking, sleep apnea can also cause heart diseases especially if it is uncontrolled as in your case your case. And heart diseases can also cause similar symptoms.
For this I want to ask few more questions.
I know it is irritating sometimes for the patient.
Some users font like if I ask questions.
So I want your permission to ask you further questions.
I will be happy to help you further. Wish you good health. Thanks.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Yes, if course. I am appreciative that you are asking questions and are thinking of solutions/ tests. Relating to the heart. I did have an electrical cardiograph done and it was fine in case that was a follow up question. My routine bloodwork is okay as well.
Brief Answer:
Have you ever undergone 2d echo?
Detailed Answer:
Thanks for your follow up question on Healthcare Magic.
I can understand your concern.
Thanks for understanding and allowing me. It's really relieving after hearing positive feedbacks fromm you.
Ecg can be normal in early heart diseases.
So please let me know
1. Have you ever undergone 2d echo?
2. Do you have edema feet in the evening or after exertion?
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.
Have you ever undergone 2d echo?
Detailed Answer:
Thanks for your follow up question on Healthcare Magic.
I can understand your concern.
Thanks for understanding and allowing me. It's really relieving after hearing positive feedbacks fromm you.
Ecg can be normal in early heart diseases.
So please let me know
1. Have you ever undergone 2d echo?
2. Do you have edema feet in the evening or after exertion?
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
Hello and Good morning.
Thanks for your response. I have not had any edema in my feet. Also, I have not had a 2d echo.
Thanks for your response. I have not had any edema in my feet. Also, I have not had a 2d echo.
Brief Answer:
It is good evening in my part of world.
Detailed Answer:
Thanks for your follow up question on Healthcare Magic.
It's good that you are not having edema feet.
And it's good evening in my part of world.
It's 9.20pm here.
Please let me know
1. How much pressure you are using in CPAP machine at present?
2. Are you using the same pressure as used in titration study?
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.
Brief Answer:
You should get done PFT and fresh sleep study.
Detailed Answer:
Thanks for your follow up question on Healthcare Magic.
I can understand your concern.
No No, I am not sleeping and it is not too late.
I usually sleeps at 12 midnight.
So you are not disturbing me.
And in my opinion, you should get done fresh sleep study and PFT.
You might need higher titration and inhaled bronchodilator and inhaled corticosteroids.
I think combination of all these will definitely help you.
Are you trying to loose weight?
Means are you doing dieting or exercise?
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.
It is good evening in my part of world.
Detailed Answer:
Thanks for your follow up question on Healthcare Magic.
It's good that you are not having edema feet.
And it's good evening in my part of world.
It's 9.20pm here.
Please let me know
1. How much pressure you are using in CPAP machine at present?
2. Are you using the same pressure as used in titration study?
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.
Brief Answer:
You should get done PFT and fresh sleep study.
Detailed Answer:
Thanks for your follow up question on Healthcare Magic.
I can understand your concern.
No No, I am not sleeping and it is not too late.
I usually sleeps at 12 midnight.
So you are not disturbing me.
And in my opinion, you should get done fresh sleep study and PFT.
You might need higher titration and inhaled bronchodilator and inhaled corticosteroids.
I think combination of all these will definitely help you.
Are you trying to loose weight?
Means are you doing dieting or exercise?
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
Hi Doc,
Yes, I think you are in XXXXXXX I lived in XXXXXXX for a year working and unfortunately got sick. Had a five day ICU stay there and have to say, it was the best medical treatment I have ever had!
Okay, to answer your questions.
The settings on the machine are go from 9 to 11 as it is a auto-setting and self adjusts. The machine is a Resmed Auto CPAP. Has a humidifier on it as well. The study suggested 9 pressure. I am wondering though, since I did not use the CPAP and switched to the Dental Apnea device for 8 months and still had throat problems, I personally ruled out the CPAP?
I know it is late there and I will look for a response from you tomorrow.
Thanks for your help..
Yes, I think you are in XXXXXXX I lived in XXXXXXX for a year working and unfortunately got sick. Had a five day ICU stay there and have to say, it was the best medical treatment I have ever had!
Okay, to answer your questions.
The settings on the machine are go from 9 to 11 as it is a auto-setting and self adjusts. The machine is a Resmed Auto CPAP. Has a humidifier on it as well. The study suggested 9 pressure. I am wondering though, since I did not use the CPAP and switched to the Dental Apnea device for 8 months and still had throat problems, I personally ruled out the CPAP?
I know it is late there and I will look for a response from you tomorrow.
Thanks for your help..
Brief Answer:
PFT will guide you about treatment.
Detailed Answer:
Thanks for your follow up question on Healthcare Magic.
I can understand your concern.
Yes, PFT will tell you whether you are having bronchitis or not.
It will also tell you about severity of the disease and treatment is based on severity only.. So PFT will determine about type of inhalers needed in your case.
And yes, you should definitely discuss all these with your doctor and get them done.
Hope I have solved your query.
If you are not having further queries, then please close the conversation and rate my answer.
You can ask me directly on bit.ly/askdrkaushalbhavsar. Do let me know your progress. Wish you good health.
Thanks
PFT will guide you about treatment.
Detailed Answer:
Thanks for your follow up question on Healthcare Magic.
I can understand your concern.
Yes, PFT will tell you whether you are having bronchitis or not.
It will also tell you about severity of the disease and treatment is based on severity only.. So PFT will determine about type of inhalers needed in your case.
And yes, you should definitely discuss all these with your doctor and get them done.
Hope I have solved your query.
If you are not having further queries, then please close the conversation and rate my answer.
You can ask me directly on bit.ly/askdrkaushalbhavsar. Do let me know your progress. Wish you good health.
Thanks
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Hi Doc,
Thanks for your reply.
I will get with my doctor and discuss the sleep study and PFT.
Will the PFT determine if I need the inhaler treatments?
Yes, I am trying to loose weight. I eat a very healthy diet, just too much.
Portion control and removing the carbs usually help me slim down. Exercise is hard to do because of the throat chest issues, I usually don't last long for cardio, etc.. So I do walks mostly. Also some stretching exercises. etc.. All light exercises.
Thanks for your reply.
I will get with my doctor and discuss the sleep study and PFT.
Will the PFT determine if I need the inhaler treatments?
Yes, I am trying to loose weight. I eat a very healthy diet, just too much.
Portion control and removing the carbs usually help me slim down. Exercise is hard to do because of the throat chest issues, I usually don't last long for cardio, etc.. So I do walks mostly. Also some stretching exercises. etc.. All light exercises.
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