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What do these PFT test results indicate?

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Posted on Mon, 14 Dec 2015
Question: We spoke a month or so back. To refresh, I have the 6 pfts that have changed little over the years, I have GAD, my mother passed away from COPD. I have had numerous Doctors including Pulmonologists indicate that I suffer from Anxious behavior and that the results of the PFT tests show that I should be fine.

I want to reflect on one physical symptom and see if the anxiety can or is the culprit. I first noticed this about 30 months ago then 18 months ago and recently it resurfaced as I start to unwind from my stress. I have a situation where if i have minor to moderate exertion, my upper chest tightens and as i try to take a breath, my lungs only let a small amount in and my lower ribs create resistance to expansion.
If my anxiety is the culprit an answer of yes is great but can you provide insight on what and why my chest, lungs etc are causing this.
If i get a good and clear understanding, I think i can accept it and work on healing.-
doctor
Answered by Dr. Alexander H. Sheppe (5 hours later)
Brief Answer:
Consultation

Detailed Answer:
Hello again! I remember you and your case very well indeed. I hope this message finds you well.

You are describing a sensation, during mild to moderate exertion, of your upper chest tightening alongside difficulty getting a full breath with a feeling of resistance.

First, let me say that this is indeed probably anxiety. When the anxious fight-or-flight mechanism in the brain is activated, out of proportion to an inappropriate stimulus in your case, the brain creates a feeling of shortness of breath, in order to stimulate you to take deeper and more full breaths to improve your oxygen supply to the muscles to prepare for running away. This results in the sensation you describe. As we have discussed, this can be treated with an SSRI.

However, it is always important to rule out medical causes of this sensation. Your PFTs are normal, as we have discussed. However, I would also encourage you to have an EKG and undergo a stress test, such as a treadmill exercise stress test, to make sure you do not have a coronary cause of this sensation. I would request this from your primary care doctor. At your age this is a possibility.

I do think this is anxiety, but to be safe we should rule out a cardiac cause. Pulmonary causes have already been ruled out.

Dr. Sheppe
XXXX
Above answer was peer-reviewed by : Dr. Raju A.T
doctor
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Follow up: Dr. Alexander H. Sheppe (26 minutes later)
Had a stress test 16 months ago. Clean XXXXXXX of health. Had ekg several times totally clean.
doctor
Answered by Dr. Alexander H. Sheppe (5 minutes later)
Brief Answer:
Followup

Detailed Answer:
You're very on top of your health and this is wonderful! This is very good news. This rules out a cardiac cause of this sensation, which points us back to anxiety, which is what I have suspected all along. Does my explanation of how this sensation is created in the brain make sense to you? Have you considered treatment with an SSRI?

Dr. Sheppe
XXXX
Above answer was peer-reviewed by : Dr. Raju A.T
doctor
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Follow up: Dr. Alexander H. Sheppe (16 hours later)
Yes it does help, in fact quite a bit thank you.
doctor
Answered by Dr. Alexander H. Sheppe (7 hours later)
Brief Answer:
Followup

Detailed Answer:
You're very welcome. Always feel free to reach out to me at my direct link with any questions or concerns you have. It's always a pleasure working with you.

Please remember to rate and close this question thread.

Dr. Sheppe
XXXX
Above answer was peer-reviewed by : Dr. Yogesh D
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Dr. Alexander H. Sheppe

Psychiatrist

Practicing since :2014

Answered : 2240 Questions

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What do these PFT test results indicate?

Brief Answer: Consultation Detailed Answer: Hello again! I remember you and your case very well indeed. I hope this message finds you well. You are describing a sensation, during mild to moderate exertion, of your upper chest tightening alongside difficulty getting a full breath with a feeling of resistance. First, let me say that this is indeed probably anxiety. When the anxious fight-or-flight mechanism in the brain is activated, out of proportion to an inappropriate stimulus in your case, the brain creates a feeling of shortness of breath, in order to stimulate you to take deeper and more full breaths to improve your oxygen supply to the muscles to prepare for running away. This results in the sensation you describe. As we have discussed, this can be treated with an SSRI. However, it is always important to rule out medical causes of this sensation. Your PFTs are normal, as we have discussed. However, I would also encourage you to have an EKG and undergo a stress test, such as a treadmill exercise stress test, to make sure you do not have a coronary cause of this sensation. I would request this from your primary care doctor. At your age this is a possibility. I do think this is anxiety, but to be safe we should rule out a cardiac cause. Pulmonary causes have already been ruled out. Dr. Sheppe XXXX