Breathing Difficulties and Coughing: When to See a Specialist?

Q: Breathing Difficulties and Coughing: When to See a Specialist?

Hello： It is recommended to consult a neurosurgeon for an evaluation of the cervical spine, and also to see a pulmonologist for a chest X-ray to check for any cardiac or pulmonary issues.

Shortness of breath and cough?

Hello Dr.
Yang, I have recently been experiencing difficulty breathing (requiring deep breaths), swallowing difficulties, dry mouth, a sensation of a foreign body in my throat, and occasional coughing.
Additionally, the muscles on the left side of my neck, near the cervical spine, are constantly tense, and tapping that area causes a sharp pain (pressing only results in soreness and numbness).
When I tap that area, it also triggers a cough, after which my breathing feels more comfortable.
Furthermore, I feel swelling in my left throat when I turn my head to the left, and my breathing feels restricted.
There is a feeling of pressure and pain in the upper left part of my chest near the center.
When I sleep on my side, regardless of which side, I feel a sense of pressure in my left chest and need to elevate my legs to feel comfortable (this has been ongoing for a month, with hot hands and cold feet).
Recently, I underwent a gastroscopy, which showed mild inflammation in my stomach (my gastroesophageal reflux has improved, and I am still on medication for my stomach).
Blood tests for my thyroid were normal.
However, the difficulty in breathing and swallowing, along with the numbness and pain on the left side of my neck, have not improved, especially under stress or when I am anxious.
Should I see a pulmonologist or a cardiologist? I apologize for the lengthy question, and thank you for your help.

Miss Huang, 30~39 year old female. Ask Date: 2020/05/16

Dr. Yang Wenda reply Pulmonology

Hello: It is recommended to consult a neurosurgeon for an evaluation of the cervical spine, and also to see a pulmonologist for a chest X-ray to check for any cardiac or pulmonary issues.

Reply Date: 2020/05/16

More Info

Breathing difficulties, persistent coughing, and sensations of discomfort in the throat can be concerning symptoms that warrant careful evaluation. Based on your description, it appears that you are experiencing a combination of respiratory and possibly musculoskeletal issues, which may be interconnected.
Firstly, the sensation of having a foreign body in your throat, along with difficulty swallowing and coughing, could indicate several underlying conditions. These may include gastroesophageal reflux disease (GERD), which can cause irritation in the throat and lead to coughing, or even a condition known as globus sensation, where one feels a lump in the throat without any actual obstruction. Since you mentioned that you have been treated for GERD, it is essential to ensure that your treatment is effective and that there are no residual effects from the reflux.

The tightness and pain in the left side of your neck and chest, especially when turning your head, could suggest a musculoskeletal issue, such as muscle strain or tension. Stress and anxiety can exacerbate these symptoms, leading to a cycle of discomfort and further anxiety. The fact that you feel better after applying pressure to the area indicates that muscle tension may play a significant role in your symptoms.

Given that you have already undergone an endoscopy and thyroid function tests, which returned normal results, it may be beneficial to explore further evaluations. If your breathing difficulties persist, especially if they are accompanied by chest pain, it is crucial to rule out any cardiac issues. Therefore, consulting a cardiologist could be a wise step to ensure that your heart is functioning well, especially since you mentioned experiencing pressure in your chest.

On the other hand, since you are experiencing significant respiratory symptoms, including the need for deep breaths and feelings of obstruction, it would also be prudent to see a pulmonologist (chest specialist). They can perform tests such as pulmonary function tests to assess your lung capacity and check for any underlying respiratory conditions, such as asthma or chronic obstructive pulmonary disease (COPD).

In summary, your symptoms suggest a multifaceted issue that may involve both respiratory and musculoskeletal components. It would be advisable to seek consultations with both a cardiologist and a pulmonologist to comprehensively evaluate your symptoms. Additionally, addressing stress and anxiety through relaxation techniques or counseling may help alleviate some of the physical symptoms you are experiencing.
In the meantime, maintaining good hydration, practicing deep breathing exercises, and avoiding known irritants (like smoke or strong odors) can help manage your symptoms. If you notice any worsening of your symptoms, such as increased difficulty breathing, chest pain, or new symptoms, do not hesitate to seek immediate medical attention. Your health and well-being are paramount, and it is essential to address these concerns with the appropriate specialists.

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