Chronic Chest Discomfort and Coughing: A Patient's Journey

Chronic chest tightness and cough?

Hello Doctor: About three years ago, I started experiencing chest tightness, located in the center of my chest where there is a protruding area.
It feels uncomfortable when I walk with my chest out, and the tightness becomes more pronounced when sitting on a chair watching TV, using the computer, or riding in a car.
At night, I often have to toss and turn in bed to find a position that alleviates the tightness enough to fall asleep.
The only time I feel comfortable during the day is within the first hour after waking up; after that, I feel very uncomfortable for the rest of the day.
Occasionally, taking a deep breath helps a bit, but the symptoms return immediately.
The most uncomfortable moments occur right after eating when my stomach feels bloated.
Over the past three years, I have visited Mackay Memorial Hospital, Ching Chuan Kang Hospital, Tzu Chi Hospital, and received traditional Chinese medicine treatments.
My mother also bought me some herbal remedies.
I have undergone X-rays, breathing tests, and an electrocardiogram during military service examinations, but no cause has been identified.
I am currently 25 years old and used to play basketball almost every day before I turned 20, but I did not have these issues back then.
One night three years ago, I suddenly decided to do push-ups after not exercising for about two years, and the next morning I experienced chest pain that has persisted ever since.
Additionally, I have a troubling issue where I feel the urge to cough continuously during the winter, but this does not happen in the summer.
Unless I make a conscious effort to suppress the cough, my throat becomes very itchy, leading to persistent coughing, and I have even been reprimanded by store clerks for it.
I am wondering if there is any medical information regarding these issues that you could recommend.
I am eager to find out the cause and see if there are any treatment options available.
Thank you!

chris, 20~29 year old female. Ask Date: 2009/12/10

Dr. Zhou Ziguang reply Pulmonology

Hello Chris,
1.
Based on the examination by the pulmonology and cardiology departments, it seems that the issue is more related to muscle or fascia injury.
However, as mentioned by your online friend, if you experience discomfort after eating, it is important to consider the possibility of gastroesophageal reflux disease (GERD).
You may want to consult with the pulmonology and gastroenterology departments for further evaluation.
2.
If you tend to have respiratory symptoms during seasonal changes, it could indicate allergic rhinitis or asthma.
It would be advisable to inquire about this during your consultation.
Thank you.
Sincerely,
Dr.
Chou Tzu-Kuang, Director of Pulmonary Function Department

Reply Date: 2009/12/10

More Info

Chronic chest discomfort and persistent coughing can be distressing symptoms that significantly impact daily life. Based on your description, it seems that you have been experiencing these symptoms for about three years, with a notable onset following a period of physical exertion after a long hiatus from exercise. This context is crucial in understanding your condition.

Firstly, the chest discomfort you describe, particularly the sensation of tightness or pressure in the center of your chest, could be attributed to several potential causes. Given your history of physical activity, it’s possible that the discomfort is related to musculoskeletal issues, such as costochondritis, which is inflammation of the cartilage connecting the ribs to the sternum. This condition can cause localized pain that worsens with certain movements or positions, which aligns with your experience of discomfort when sitting or lying down.

Another possibility is that your symptoms could be related to gastrointestinal issues, such as gastroesophageal reflux disease (GERD). The fact that you experience increased discomfort after eating and when your stomach feels full suggests that acid reflux might be a contributing factor. GERD can cause chest pain that mimics cardiac pain and is often accompanied by symptoms like coughing, especially if stomach acid irritates the throat.

The persistent cough you experience during winter could indicate a seasonal allergy or respiratory condition, such as asthma. Asthma can cause coughing, especially in response to cold air or allergens, and may not be present in warmer months. The fact that you feel an itch in your throat leading to coughing suggests that there may be an irritant or allergen involved.

Given that you have undergone various tests, including X-rays, pulmonary function tests, and electrocardiograms, and have not found a definitive cause, it may be beneficial to consider a few additional steps:
1. Consult a Specialist: Since your symptoms are chronic and have not improved with general medical evaluations, seeing a pulmonologist or a gastroenterologist may provide more targeted insights. They can conduct specific tests, such as a pH probe for acid reflux or a more detailed lung function test.

2. Lifestyle Modifications: Keeping a symptom diary can help identify triggers related to your diet, activities, or environmental factors. Additionally, consider dietary changes to reduce potential reflux symptoms, such as avoiding spicy or fatty foods, caffeine, and large meals.

3. Physical Therapy: If musculoskeletal issues are suspected, physical therapy may help alleviate discomfort through targeted exercises and stretches.

4. Allergy Testing: If you suspect allergies, especially since your cough is seasonal, allergy testing may help identify specific triggers, allowing you to manage your environment better.

5. Medication Review: If you are currently taking any medications or supplements, review these with your healthcare provider to ensure they are not contributing to your symptoms.

6. Stress Management: Chronic symptoms can be exacerbated by stress. Engaging in relaxation techniques, such as mindfulness or yoga, may help alleviate some discomfort.

In conclusion, while your symptoms have been persistent and challenging, there are various avenues to explore for diagnosis and treatment. It’s essential to communicate openly with your healthcare providers about your concerns and the impact these symptoms have on your quality of life. With a comprehensive approach, including specialist consultations and lifestyle adjustments, you may find relief and a clearer understanding of your condition.

Similar Q&A

Persistent Cough and Chest Pain: When to Seek Medical Attention?

Hello Doctor: I started experiencing persistent coughing every night between 11 PM and 1 AM about a week ago, which is more pronounced when lying down compared to other positions. I feel an unbearable itch in my throat around the area between my collarbones, but there is no phleg...

Dr. Yang Wenda reply Pulmonology
Hello Sam: Based on your respiratory history, including a history of pneumothorax, allergic rhinitis, and chest pain (possibly neuropathic pain), if your symptoms are not too severe, you may choose to monitor your condition. It is advisable to drink plenty of warm water and avoid...

Understanding Chest Pain and Cough: Seeking Effective Treatment Options

Hello, Doctor. Since around the middle of last year, I have been experiencing severe coughing at night/midnight, which I initially thought was due to an unresolved cold (I returned from Europe at the end of March with a cold, and after taking two or three packets of medication, I...

Dr. Huang Yiwen reply Pulmonology
Dear K: I apologize for the delayed response due to the holiday. Based on your symptom description, it is likely that you have atypical asthma. However, the treatment approach needs to be adjusted. You can start with inhaled corticosteroids for control, or you may visit the outpa...

Understanding Cough and Chest Pain: When to See a Specialist

I have high blood pressure and elevated blood sugar levels. Starting on November 26, I caught a cold, initially experiencing symptoms such as a runny nose, sneezing, nasal congestion, and a sore throat. By November 27, the sore throat had resolved, but I began to cough and produc...

Dr. Guo Hongyi reply Pulmonology
Hello, the public. Online consultations are not available. We still recommend that you visit the thoracic medicine outpatient clinic in person. Thank you for your inquiry.

Chronic Left Chest Pain and Persistent Cough: Possible Causes and Solutions

I have a female friend who has been experiencing pain below her left chest for several years. She almost constantly produces phlegm, which is often yellow and sometimes white. She feels numbness, and deep breathing causes pain, sometimes to the point of difficulty breathing. In t...

Dr. Jiang Junyi reply Neurology
Hello: Your friend is suffering from a difficult-to-treat illness. It is advisable to avoid multiple hospital visits and instead find a single medical center to focus on. After all, the physicians at the same hospital will have access to the same diagnostic information, which can...