the Impact of Inhalers on Chest Discomfort: A Patient's Inquiry

Q: the Impact of Inhalers on Chest Discomfort: A Patient's Inquiry

Hello： You are using a bronchodilator, and there has been improvement, which is more indicative of asthma symptoms. <br>The normal dosage is to inhale two puffs in the morning and evening. <br>During the summer, if symptoms improve, some may reduce it to one puff in the morning a

Please ask some questions about bronchodilators?

Hello Dr.
Yang,
A family member started using a bronchodilator inhaler about two to three years ago due to coughing (approximately 1-2 times daily, often lasting for several minutes).
After stabilizing the symptoms, the dosage was reduced to one puff every morning, which has been maintained until now.
Over the past two weeks, she has begun experiencing daily chest tightness, which persists throughout the day after waking up.
Yesterday, she visited a cardiologist who confirmed that the electrocardiogram (ECG) was normal but advised against immediately performing an exercise stress test due to the possibility of false positives.
Blood tests were arranged, and she is scheduled to review the results next week.
The doctor mentioned that at her age, it is often related to muscle strain, among other things.

Later, we noted that a common side effect of the bronchodilator is palpitations, and she does occasionally feel her heartbeat.
Additionally, after the passing of a pet, some nasal-related symptoms improved, leading us to suspect that the initial cough may have been related to allergies.

I would like to ask if it is possible to discontinue the bronchodilator to observe if it is the primary cause of her chest tightness.
If so, what would be the appropriate method for tapering off the medication, and how should the dosage be adjusted if it needs to be resumed later?
Thank you for your assistance! Wishing you peace and health.

Niming, 30~39 year old female. Ask Date: 2020/09/30

Dr. Yang Wenda reply Pulmonology

Hello: You are using a bronchodilator, and there has been improvement, which is more indicative of asthma symptoms.
The normal dosage is to inhale two puffs in the morning and evening.
During the summer, if symptoms improve, some may reduce it to one puff in the morning and evening.
Currently, inhaling only one puff a day may not be sufficient, especially with the recent significant temperature fluctuations between morning and evening.
It is recommended to return to the dosage of two puffs in the morning and evening, and also to consider a follow-up evaluation with a pulmonologist.

Reply Date: 2020/09/30

More Info

Hello, thank you for your inquiry regarding the use of inhalers and their potential impact on chest discomfort. It sounds like your family member has been managing a chronic cough with a bronchodilator inhaler, and now is experiencing new symptoms of chest tightness. I understand your concerns, especially given the recent medical evaluations and the emotional context surrounding the loss of a pet.

Bronchodilators, such as the one your family member is using, are commonly prescribed for conditions like asthma or chronic obstructive pulmonary disease (COPD). They work by relaxing the muscles around the airways, making it easier to breathe. However, they can also have side effects, including palpitations or increased heart rate, which may contribute to feelings of chest discomfort or anxiety.

Given that the heart evaluation has returned normal results, it is reasonable to consider whether the inhaler could be contributing to the chest tightness. If the inhaler is suspected to be the cause of the new symptoms, it may be appropriate to discuss with the prescribing physician the possibility of temporarily discontinuing its use to see if the symptoms improve. However, this should be done under medical supervision to ensure safety and to monitor for any potential worsening of respiratory symptoms.

If the decision is made to stop using the inhaler, it is important to do so gradually rather than abruptly, especially if the inhaler has been used regularly for an extended period. The physician can provide guidance on how to taper the medication safely. Typically, this might involve reducing the frequency of use before stopping completely, but the exact method should be tailored to the individual’s needs and medical history.

In terms of monitoring for symptoms, it would be wise to keep a diary of any changes in chest discomfort, respiratory symptoms, and overall well-being during this period. If symptoms worsen or new symptoms arise, it is crucial to seek medical attention promptly.

Additionally, considering the emotional context of your family member's situation, it may be beneficial to address any anxiety or stress that could be contributing to the perception of chest discomfort. Stress and anxiety can manifest physically, leading to symptoms such as tightness in the chest, which may not necessarily be related to a physical condition.

In conclusion, while it may be reasonable to consider stopping the inhaler to see if it alleviates the chest discomfort, this should be done with the guidance of a healthcare professional. They can provide a tailored approach to discontinuing the medication and monitor for any changes in symptoms. It is also important to consider the psychological aspects of health, as emotional well-being can significantly impact physical symptoms. If anxiety persists, seeking support from a mental health professional may also be beneficial.
Wishing you and your family member good health and peace of mind.

Similar Q&A

Managing Discomfort from Long-Acting Asthma Inhalers: Tips and Insights

We are using long-acting bronchodilators (which are said to contain steroids) due to our medical condition. However, after using them in the morning and evening, we experience a significant increase in heart rate and slight trembling in our hands. These symptoms last for about 1-...

Dr. Qu Changke reply Pulmonology
Hello, syndrome.tw: Here is the response: Although inhaled bronchodilators can cause side effects such as increased heart rate and hand tremors, they are usually not severe and are generally within tolerable limits. Are you currently using any other medications? It is recommended...

Understanding Heart Pain: Asthma, Medications, and Potential Risks

I have asthma, and I have been using maintenance medication for it. My doctor mentioned that the side effects of that medication are minimal. Recently, I've been experiencing intermittent chest pain that comes and goes. I started having these episodes in high school, but the...

Dr. Lin Jizhi reply Internal Medicine
During puberty, emotional fluctuations or excitement often lead to a sensation of sharp pain, which typically resolves quickly. This is likely neuropathic pain caused by issues with the autonomic nervous system and should not be attributed to heart problems. Additionally, the use...

Persistent Chest Discomfort: Understanding Causes and Treatment Options

Hello Dr. Kuo, I have been experiencing long-term discomfort that began after I underwent gynecological surgery in March 1998, during which I had anesthesia and intubation. Following the surgery, I coughed up blood for several days and felt as if there was phlegm stuck in my ri...

Dr. Guo Conghuai reply Internal Medicine
Hello Miss Green: Based on your description, it seems that you have been troubled for quite a long time. You may be a patient who becomes anxious and has difficulty sleeping over minor issues (Mitral Valve Prolapse Syndrome). If your lung function indicates that you truly have br...

Managing Chest Discomfort with Allergies: When to Seek Help

Recently, I visited the allergy clinic and discovered some allergens. The doctor advised me to regularly wash my bed linens and covers, but I still experience discomfort in my chest. Although I was prescribed a nasal spray, its effectiveness seems limited. Sometimes, when I go to...

Dr. Yang Wenda reply Pulmonology
Hello: It is recommended that you see a pulmonologist and arrange for a pulmonary function test (spirometry) to check for any asthma symptoms!