Breathing Difficulties in Stuffy Spaces: Is It Related to Past Asthma?

Breathing difficulties occur in places without air conditioning?

Hello, Doctor.
I have a history of allergic asthma in my childhood, but it gradually disappeared after puberty.
However, I have been puzzled for a long time by a condition where I feel chest tightness and difficulty breathing whenever I am in poorly ventilated places or in open spaces without air conditioning.
I notice that the people around me usually just feel uncomfortable, but I seem to experience symptoms that escalate to tinnitus and a sense of impending fainting if I stay too long, prompting me to quickly find a place with airflow.
I have wondered if this could be a manifestation of claustrophobia, but even in a small room with closed doors and windows, as long as there is airflow, I have no issues.
For example, a few weeks ago, I visited a major medical center for a weekend morning appointment.
Due to a high volume of patients, my wait extended into the afternoon.
I was focused on reading a leisure magazine and did not realize that the hospital had turned off the air conditioning in the waiting area at noon.
As I waited, I began to experience difficulty breathing, felt like I was suffocating, and started to feel nauseous, verbally expressing my discomfort to those around me.
A fellow patient informed me that "the hospital has turned off the air conditioning." This situation aligns with what I described, so I would like to ask the doctor if this is related to my past asthma issues (could my lung function be affected due to asthma?).
Is this a manifestation of a medical condition? Thank you very much!

Miss Pan, 30~39 year old female. Ask Date: 2013/08/04

Dr. Gao Jiankai reply Internal Medicine

Hello, thank you for your inquiry.
After the cessation of air circulation, it is indeed possible for symptoms of chest tightness to worsen, especially in patients with a history of asthma.
However, whether this is related to childhood asthma requires further examination.
In principle, we will first assume that there is a physiological issue, particularly in patients with a past history of asthma.
Therefore, we will arrange for pulmonary function tests to determine if early asthma has caused airway sensitivity or narrowing.
Once the pulmonary function results are normal, we will then consider the possibility of cardiac or even psychological issues.
Therefore, please consult with a pulmonologist or an allergist/immunologist, who can arrange for the necessary tests or even subsequent referrals.
The Allergy, Immunology, and Rheumatology Department at Changhua Hospital, Ministry of Health and Welfare, is here to assist you.

Reply Date: 2013/08/04

More Info

Breathing difficulties in stuffy spaces can indeed be related to a history of asthma, especially if you have experienced allergic asthma in your childhood. While asthma symptoms may have diminished during your teenage years, the underlying airway hyperreactivity may still persist, making you more sensitive to environmental triggers, such as poor air circulation or high levels of allergens in the air.

Asthma is characterized by inflammation and narrowing of the airways, which can lead to symptoms like wheezing, coughing, chest tightness, and shortness of breath. Even if you are not currently experiencing classic asthma symptoms, your airways may still react more strongly to certain stimuli, such as stagnant air or allergens. This could explain why you feel chest tightness and difficulty breathing in environments where the air is not circulating well.

Your experience of feeling lightheaded or on the verge of fainting when in a stuffy environment could also be attributed to a combination of anxiety and physical discomfort. The sensation of not being able to breathe properly can trigger a panic response, leading to further feelings of distress. This is particularly relevant if you have a history of anxiety or panic attacks, as the body can react strongly to perceived threats, including difficulty breathing.

It's important to note that while your past asthma history may contribute to your current symptoms, other factors could also be at play. For instance, nasal obstruction due to conditions like a deviated septum or nasal polyps can lead to difficulty breathing through the nose, which may exacerbate feelings of breathlessness, especially in confined spaces. Additionally, obesity can contribute to breathing difficulties, as excess weight can put pressure on the chest and lungs, making it harder to breathe comfortably.

To address your concerns, it would be beneficial to undergo a thorough evaluation by a healthcare professional. This may include pulmonary function tests to assess your lung capacity and airway responsiveness. If your lung function is normal, it may be worthwhile to explore other potential causes of your symptoms, such as anxiety disorders or structural issues in your nasal passages.

In the meantime, here are some strategies that may help alleviate your symptoms:
1. Controlled Breathing Techniques: Practicing deep breathing exercises can help calm your nervous system and improve your sense of breath control. Techniques such as diaphragmatic breathing or pursed-lip breathing can be effective.

2. Environmental Modifications: If you know you will be in a stuffy environment, try to ensure that there is adequate ventilation. If possible, bring a portable fan or find a way to create airflow.

3. Stay Hydrated: Dehydration can exacerbate feelings of discomfort, so make sure you are drinking enough fluids.

4. Seek Professional Help: If your symptoms persist or worsen, consider consulting with a pulmonologist or an allergist. They can provide tailored advice and treatment options based on your specific situation.

5. Mental Health Support: If anxiety is a significant factor in your breathing difficulties, consider speaking with a mental health professional who can help you develop coping strategies.

In conclusion, while your past asthma may play a role in your current breathing difficulties, it is essential to consider a holistic approach that includes both physical and psychological factors. A thorough evaluation by a healthcare provider will help clarify the underlying causes and guide you toward effective management strategies.

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