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What Does This Chest X-ray Report Indicate?
Question: Hi, I had no symptoms then got a viral infection. Turned out was acute bronchitis. At the time I had a chest X-ray which said mild airway inflammation and peribronchial wall thickening. GP or radiologist weren't concerned. Infection (fever, slight productive cough, fatigue) went after 2 weeks. I had mild asthma as a child and post nasal drip and bronchospasm to many irritants as an adult. I was a light smoker and doctors always said chest showed no sign of smoking damage. I am a highly anxious person and always worry about smoking diseases. I never have had a smokers cough, productive cough ever. I never had any breathing problems or wheeze as an adult either. Even though main infection went I at time since virus get a dry wheeze, tickly throat and a bit breathless. The doctors Think it is hyperventilating as I also get pins and needles in my legs. Both wheezing and pins and needles only occurred since virus none ever before. Of course I worry if doctors are wrong. They say lungs sound clear and is hyperventilating or just residual dry cough. Is this correct? As I said never had any issues before bronchitis infection and since the X-ray my anxiety is severe. GP assured me radiologist would ring him if concerned and I got 3 GP's to look at X-ray and all said not smoking related. So do you think still just left over from bronchitis, or anxiety attacks? Could I have asthma returned following infection? Please tell me you don't think any smoking cause when have stopped and never had any problem when smoked or abnormal X-rays before bronchitis?
Brief Answer:
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Detailed Answer:
I read your question carefully and I understand your concern.
Regarding asthma, the fact that you have an asthmatic background does mean that you have a hypersensitive tendency and in the setting of an infection can develop asthmatic symptoms. Of course that makes it more difficult to definitely clear away bronchitis, takes more time. If that is the case it can be a temporary reaction, it doesn't mean that you will definitely develop asthma. Also the symptoms are inconclusive, if the doctors find no signs on examination they may be right about the hyperventilation thing, pins and needles are not a typical manifestation and you have found out yourself to be more anxious (anxiety is related to hyperventilation). So it is not always easy to differentiate between the two, can even play a role combined.
As for the smoking issue I do not think that is related. If as you say you were a light smoker and have quit for years it shouldn't have left any important consequences and shouldn't be blamed. The normal xray confirms that.
I remain at your disposal for other questions.
Read below
Detailed Answer:
I read your question carefully and I understand your concern.
Regarding asthma, the fact that you have an asthmatic background does mean that you have a hypersensitive tendency and in the setting of an infection can develop asthmatic symptoms. Of course that makes it more difficult to definitely clear away bronchitis, takes more time. If that is the case it can be a temporary reaction, it doesn't mean that you will definitely develop asthma. Also the symptoms are inconclusive, if the doctors find no signs on examination they may be right about the hyperventilation thing, pins and needles are not a typical manifestation and you have found out yourself to be more anxious (anxiety is related to hyperventilation). So it is not always easy to differentiate between the two, can even play a role combined.
As for the smoking issue I do not think that is related. If as you say you were a light smoker and have quit for years it shouldn't have left any important consequences and shouldn't be blamed. The normal xray confirms that.
I remain at your disposal for other questions.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Thank you for replying.
I only quit smoking 6 months ago and thought it was a good time as I had no symptoms until acute bronchitis following an upper Resp infection 6 weeks ago. GP gave me a portable peak flow meter and I appear to be 400 most times but drops to 370 when I feel wheezy and sob. I was initially given Symbicort inhaler and recently Ventolin but made no difference. I did a spirometry test and was 1% lower than normal but doctor said it is fine and that having bronchitis at time of test would lower result anyway. as stated previously I never had any breathing issues till bronchitis but any illness, X-ray etc will panic me. If hyperventilating would that temporarily lower peak flow? Is 400/700 normal for 42 yr old female height 163cm weight 62 kg?
As I can be fine and then suddenly start feeling breathless and wheezing and needing to inhale more, is that sudden out of the blue more like asthma or hyperventilating, chest infection or what? Do you agree that my peak flow is ok, that spirometry ok when was in the middle of bronchitis during test? And that X-ray etc does not relate to past smoking? And that these post bronchitis symptoms are either residual or anxiety?
I only quit smoking 6 months ago and thought it was a good time as I had no symptoms until acute bronchitis following an upper Resp infection 6 weeks ago. GP gave me a portable peak flow meter and I appear to be 400 most times but drops to 370 when I feel wheezy and sob. I was initially given Symbicort inhaler and recently Ventolin but made no difference. I did a spirometry test and was 1% lower than normal but doctor said it is fine and that having bronchitis at time of test would lower result anyway. as stated previously I never had any breathing issues till bronchitis but any illness, X-ray etc will panic me. If hyperventilating would that temporarily lower peak flow? Is 400/700 normal for 42 yr old female height 163cm weight 62 kg?
As I can be fine and then suddenly start feeling breathless and wheezing and needing to inhale more, is that sudden out of the blue more like asthma or hyperventilating, chest infection or what? Do you agree that my peak flow is ok, that spirometry ok when was in the middle of bronchitis during test? And that X-ray etc does not relate to past smoking? And that these post bronchitis symptoms are either residual or anxiety?
Brief Answer:
Read below
Detailed Answer:
Hello again!
A spirometry test showing only 1% lower than normal is not bad, if bronchitis was in play it's not bad at all. As for the 400/700 figure it is somewhat low, but if you are anxious and hyperventilating, you mention even sobbing, then it might be that you aren't fully pushing air out of the lungs, aren't blowing to your real maximal capacity.
Sudden lack of breath as you describe is not due to infection, at least not completely, in case of infection should be more persistent. Between asthma attack and hyperventilation the fact that you mention wheezing makes me sway in the favor of the attack (if such wheezing was verified by doctor on auscultation), as hyperventilation shouldn't include wheezing as well.
You shouldn't try to separate as you seem to want to do asthma from infection though. The two are often associated and each can potentiate the other. That means that infection can induce asthma like attack (spasms of the bronchi) and such attacks in turn predisposes for infection which is difficult to eradicate. So that is why Symbicort and Ventolin may not be as effective and need some time. In time with the infectious factor not present anymore inflammation and attacks should subside.
Since prior Xrays were fine I do not see why you should think abnormal xray should result from previous smoking. With quitting there is no further damage even if there is any residual damage not detected by xray it should be really minor.
I hope to have been of help.
Read below
Detailed Answer:
Hello again!
A spirometry test showing only 1% lower than normal is not bad, if bronchitis was in play it's not bad at all. As for the 400/700 figure it is somewhat low, but if you are anxious and hyperventilating, you mention even sobbing, then it might be that you aren't fully pushing air out of the lungs, aren't blowing to your real maximal capacity.
Sudden lack of breath as you describe is not due to infection, at least not completely, in case of infection should be more persistent. Between asthma attack and hyperventilation the fact that you mention wheezing makes me sway in the favor of the attack (if such wheezing was verified by doctor on auscultation), as hyperventilation shouldn't include wheezing as well.
You shouldn't try to separate as you seem to want to do asthma from infection though. The two are often associated and each can potentiate the other. That means that infection can induce asthma like attack (spasms of the bronchi) and such attacks in turn predisposes for infection which is difficult to eradicate. So that is why Symbicort and Ventolin may not be as effective and need some time. In time with the infectious factor not present anymore inflammation and attacks should subside.
Since prior Xrays were fine I do not see why you should think abnormal xray should result from previous smoking. With quitting there is no further damage even if there is any residual damage not detected by xray it should be really minor.
I hope to have been of help.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
With regards to X-ray earlier X-rays said no lung disease and lungs normal so when got last X-ray that had inflammation and peribronchial thickening I panicked not knowing what it meant. In regards to breathing I have never been a strong breather my whole life in addition to having asthma as a child. I am not prone to lung infections usually I get upper Resp throat infections. Have many allergic reactions to irritants causing wheezing, coughing and shortness of breath ie paint, perfume, alcohol...
So I assume hypersensitive airways as well as upper nasal blockage from deviated septum. I assume XXXXXXX is ok if didn't have bronchitis at time. My doctors said peak flow was average for my age. As I had asthma as a child even though seem to go as an adult would that cause a naturally low normal spirometry reading still? Again would past asthma cause peak flow to stay lower normal? Not sobbing - shortness of breath I have when hyperventilating- would hyperventilating temporarily lower peak flow?
GP could not hear wheezing and said lungs are clear. Would blocked nose (upper) cause shortness of breath as blocked and then can mucus in throat (sinus) block throat to cause wheeze?
I never had a productive cough in my life and only since acute bronchitis did I first get a wheeze. Prior to infection I had no problem so this has to be related to bronchitis infection even though that had long gone.
So I assume hypersensitive airways as well as upper nasal blockage from deviated septum. I assume XXXXXXX is ok if didn't have bronchitis at time. My doctors said peak flow was average for my age. As I had asthma as a child even though seem to go as an adult would that cause a naturally low normal spirometry reading still? Again would past asthma cause peak flow to stay lower normal? Not sobbing - shortness of breath I have when hyperventilating- would hyperventilating temporarily lower peak flow?
GP could not hear wheezing and said lungs are clear. Would blocked nose (upper) cause shortness of breath as blocked and then can mucus in throat (sinus) block throat to cause wheeze?
I never had a productive cough in my life and only since acute bronchitis did I first get a wheeze. Prior to infection I had no problem so this has to be related to bronchitis infection even though that had long gone.
Brief Answer:
Read below
Detailed Answer:
Thank you for the additional info and sorry for not being able to answer a bit earlier.
The fact that previous xrays were normal as I said reinforces that it is not related to permanent smoking changes, those findings are what is expected in bronchitis.
XXXXXXX as I said is ok. I wouldn't call 400/700 normal for the age as your doctors say, but hyperventilation can affect its results. If you hyperventilate due to anxiety, breathing at an increased rate, you would not give your best performance on peak flow measurement. It measures the maximal peak flow, the best performance, so can be lowered by hyperventilation.
Blocked nose can make breathing difficult, forcing to breathe by mouth, but this shouldn't be in sudden attacks as you describe them. Neither does throat obstruction cause wheezing, when severe (do not think your case) can cause another type of noise called stridor, but not wheezing.
To return to the asthma issue, you shouldn't think of it as either being there or not at all. The childhood attacks and the allergic reactions you describe make it obvious you are hypersensitive, always prone to spasms. You'll probably always be prone to that, you will have that type of background whether you have attacks or not. It is just that in certain conditions such as bronchitis infection in this case (or chemical irritants like perfume in the past), you'll cross the threshold beyond which this reactivity may produce symptoms in the form of attacks. Whether it is the case for your attacks, whether they are such attacks or due to anxiety, it can be difficult to distinguish at times. If there is objective wheezing I would consider them as related to bronchospasm, otherwise if exam during attack is normal, no wheezing or other findings, anxiety can well explain the rest.
Read below
Detailed Answer:
Thank you for the additional info and sorry for not being able to answer a bit earlier.
The fact that previous xrays were normal as I said reinforces that it is not related to permanent smoking changes, those findings are what is expected in bronchitis.
XXXXXXX as I said is ok. I wouldn't call 400/700 normal for the age as your doctors say, but hyperventilation can affect its results. If you hyperventilate due to anxiety, breathing at an increased rate, you would not give your best performance on peak flow measurement. It measures the maximal peak flow, the best performance, so can be lowered by hyperventilation.
Blocked nose can make breathing difficult, forcing to breathe by mouth, but this shouldn't be in sudden attacks as you describe them. Neither does throat obstruction cause wheezing, when severe (do not think your case) can cause another type of noise called stridor, but not wheezing.
To return to the asthma issue, you shouldn't think of it as either being there or not at all. The childhood attacks and the allergic reactions you describe make it obvious you are hypersensitive, always prone to spasms. You'll probably always be prone to that, you will have that type of background whether you have attacks or not. It is just that in certain conditions such as bronchitis infection in this case (or chemical irritants like perfume in the past), you'll cross the threshold beyond which this reactivity may produce symptoms in the form of attacks. Whether it is the case for your attacks, whether they are such attacks or due to anxiety, it can be difficult to distinguish at times. If there is objective wheezing I would consider them as related to bronchospasm, otherwise if exam during attack is normal, no wheezing or other findings, anxiety can well explain the rest.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
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