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Family Physician
Family Physician, Doctor
Category: Medical
Satisfied Customers: 2592
Experience:  Emergency Medicine and Family Practice for over 26 years
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I have this weird sensation in my upperchest, collarbone,

Customer Question

I have this weird sensation in my upperchest, collarbone, throat. I think where airways are located. Feels like heaviness or pressure. It normally comes and goes but lately stays continuously. It seems to be relieved lying down and sitting. As soon as go to walk gets worse. When I have this, and try to exhale, I let out a small cough at the end of the exhale. Lung xray normal and dr. doesn't hear wheezing. Also have been having bouts of tachycardia lasting hours, which has settled down since I started beta blockers. Could this be bronco spasm. Had it really bad yesterday trying to walk from parking lot into store. Legs were also very heavy and tired.
Submitted: 17 days ago.
Category: Medical
Expert:  drcaplan replied 17 days ago.

Hello!

Welcome to the JustAnswer.com question/answer interface.

I am a Family Medicine doctor, board certified with active licenses and certification in Internal Medicine, Pediatrics, Obstetrics and Gynecology, as well as Integrative Medicine & Naturopathy, with advanced training in Neurology, Cardiovascular Medicine, Gastroenterology, Endocrinology, and Psychiatry. I am also well-trained in Functional Medicine. For your review, here is my direct link with my current ratings: http://www.justanswer.com/medical/expert-familydoctor/

I have read your post and observations about the sensations in your upper body. Would you prefer a summary answer to your question, or would you prefer more back-and-forth, where there will be a series of more questions and more details clarified? There is no difference in charges for your preference. You can continue to ask questions and receive answers without additional charges.

Either way, I’ll do my best to take the appropriate time to help you.

Expert:  drcaplan replied 17 days ago.

To address your direct question, you are certainly at risk for bronchospasm, and the end-expiratory cough that you describe sounds bronchospastic, but... this doesn't typically come on out of nowhere. Has anyone ever given you inhalers in the past?

Customer: replied 17 days ago.
back and forth would be good. No. I normally have this symptom bad when I have tachycardia, but now seem to be having it constantly. Would it be present constantly or does it come as an attack and go away and lasting how long?
Expert:  drcaplan replied 17 days ago.

you got it!

Expert:  drcaplan replied 17 days ago.

You're taking beta blockers for the tachycardia?

Expert:  drcaplan replied 17 days ago.

some beta blockers can give patients some breathing changes. Do you think this could be related in your case?

Expert:  drcaplan replied 17 days ago.

Bronchospasm does come and go with attacks and resolves naturally.

Expert:  drcaplan replied 17 days ago.

It is easily triggered, and considering the climate changes we are all experiencing, even a "normal" set of lungs and bronchi could experience spasm.

Customer: replied 17 days ago.
Just started taking Altenolol 3 days ago. I had this symptom before taking, but it feels much worse. My dr says that Altenolol only blocks beta 1 heart receptor and not lung, so this shouldn't be an issue even if having bronco spasm. Will the breathing changes with beta blocker go away. I just started taking it 3 days ago. Is this from lower oxygen levels due to heart pumping less hard?
Expert:  drcaplan replied 17 days ago.

I see. correct. other betablockers induce more bronchospasm.

Expert:  drcaplan replied 17 days ago.

it's very very unlikely that this is affecting your oxygen levels.

Expert:  drcaplan replied 17 days ago.

If the betablocker WERE causing your symptoms, which I dont' think it is, given that you're on atenolol, but if it were, we would expect your system to become used to them (and their effects more tempered) after weeks to months. Again, especially since your symptoms predated the medication, I don't think that's the cause

Expert:  drcaplan replied 17 days ago.

Have you tried an alpha agonist, or an antihistamine (pseudophed and zyrtec/allegra/claritin) ?

Customer: replied 17 days ago.
No. I only take Losartan and Beta Blocker. He didn't want to give me Albuterol, because I tend to have tachy cardia and high adrenal response. He doesn't think I have bronco spasm. This symptom is present most all of the time, gets worse though when exertion picks up. Would this cause tachycardia? I also would it be present all of the time?
Expert:  drcaplan replied 17 days ago.

I see. The losartan is a risk factor that could be contributing to your symptoms. have you considered that? how long

Expert:  drcaplan replied 17 days ago.

have you been taking it? would what cause tachycardia? Losartan? No.

Expert:  drcaplan replied 17 days ago.

One of the other possible causes of your cough is acid reflux, has that ever been an issue for you?

Expert:  drcaplan replied 17 days ago.

bronchospasm could cause some elevated heart rates, but not persistent tachycardia. bronchospasm can come and go, and "tachycardia" can be a symptom that varies for innumerable reasons.

Customer: replied 17 days ago.
Been on Losartan since June of 2015.
Also, I am schedule to do an echo stress test on Tuesday. Will I have to go off Beta Blocker for this test?
Customer: replied 17 days ago.
I have had acid reflux in the past. Don't really take anything regularly. Once in awhile will take Pepcid Complete. This cough seems to only be present at the end of an exhale though.
Expert:  drcaplan replied 17 days ago.

The losartan probably not involved then. One could argue the echo would be a more useful test without the beta blocker on board, but it's also not representative of what you're doing at baseline, so their recommnedations of your testing conditions could go either way. I'm not sure.

Expert:  drcaplan replied 17 days ago.

Hm... The end expiration component is an important piece. That suggests some reactive airway disease, and a medication like albuterol might help relief that discomfort.