Lung and Respiratory Diseases

Breathing Difficulties

10/24/1999 10:35PM

Question:

I am a 26 year-old male and have been experiencing breathing problems for about 6 months. The problem is that I have difficulty taking a full breath, it seems I can`t inhale after about 3/4 of the breath. I take a couple seconds, and inhale again and usually can get the full breath in. This occurs for a couple of days, then goes away for a few.
I have been to three doctors about this problem. I have taken a breathing test where they told me my lungs were that of an 18 year-old, I also blew the peak flow meter off the chart. Chest X-rays and blood tests have not revealed anything.
What direction should I go in to resolve this problem?

Answer:

One of the more difficult issues in pulmonary medicine is the concept of dyspnea, which is the sensation of not getting enough air. Often, dyspnea is associated with some physiologic problem (such as asthma, emphysema, etc) but sometimes the cause is not that obvious. In your case, the fact that you are young and have had at least a screening lung function test (I can`t tell how good based upon your description) suggests that whatever the cause, it is not likely to be a serious condition. Nevertheless, we would all feel better knowing what it is that is bothering you, so what should you do?
I would start by making sure that your lung evaluation is in fact complete. Many generalists order cursory lung screening tests, such as the peak flow you described. Peak flows are great for patients who need a test they can do at home to follow their condition, but they are not very sophisticated and do not measure a variety of other lung parameters that may be helpful. If you have not seen a real lung specialist and had formal lung function studies performed, I would do so. In particular, I would be interested in whether you have any early evidence of lung restriction or diffusion abnormalities, which may indicate the early onset of certain lung problems that may present in the manner you describe. Also, formal testing is usually more sensitive in picking up early asthma and other obstructive problems.
If you`ve already had such tests, or the tests turn up nothing, then I would consider whether your symptoms have nothing to do with your lungs but rather reflect a chest wall condition. Although fairly unusual, certain forms of arthritis can present in young people, and can affect the ribs, sternum and assiciated joints to cause discomfort. A thorough physical examination, along with some specialized blood tests, will often suggest this diagnosis.
One more thing should be considered: do your symptoms typically occur at the same time of the week (i.e., worse on Fridays, best on Mondays, etc)? If so, you may be suffering from an occupational or other environmental exposure of which you are otherwise unaware. Did you get a new job in the past year? These problems are actually more common than you might think. NetWellness has some excellent experts in this field, so if you think your symptoms may fit in this category, please write back and we`ll be sure to address this issue in more detail.

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Response by:

Stuart Green, MD
Assistant Professor of Medicine and Pathobiology
Pulmonary, Critical Care & Sleep Medicine
Department of Internal Medicine
College of Medicine
University of Cincinnati