Asthma as a Cause of Chest Pain and Breathing Difficulty

Understanding Asthma Chest Pain

Chest pain can be a scary symptom to experience. While it may feel like your heart or lungs are in distress, there are many potential causes behind chest discomfort. One possible culprit is asthma.

Asthma is a chronic lung condition that inflames and narrows the airways of the lungs. This inflammation makes breathing difficult and can trigger coughing, wheezing, shortness of breath, and tightening chest sensations. While asthma is typically associated with wheezing and trouble breathing, chest tightness and pain are also common asthma symptoms.

What Causes Chest Pain With Asthma?

During an asthma attack, the airways become severely inflamed and constricted. As you struggle to breathe against this narrowed airway, sharp chest pains may occur. Several factors can provoke asthma-related chest discomfort:

• Trying to force air through inflamed, contracted airways
• Coughing fits aggravated by asthmatic inflammation
• Expanded lungs over-stretching inflamed airways
• Strained chest muscles attempting to breathe deeply

As asthma makes breathing laborious, the heavy work of inhaling and exhaling can strain the chest muscles surrounding the lungs. This muscular tension and fatigue builds up over time, leading to chest tightness and soreness.

Asthma Chest Pain Location

Where you experience chest pain can indicate whether asthma is the likely cause. Asthma-related chest discomfort typically centers around the lungs, airways, and surrounding musculature.

Common locations include:

• Along the breastbone (sternum)
• Below the collarbones
• Off to one or both sides of the chest
• Across the upper abdomen during breathing

This stands in contrast to cardiac chest pain, which classically centers in the middle of the chest behind the sternum. With heart-related chest pain, you may also feel discomfort in the shoulders, arms, neck, or jaw.

Other Asthma Chest Pain Characteristics

Beyond location, certain descriptive factors can indicate whether asthma is generating your chest discomfort:

• Tightness - An uncomfortable sensation of squeezing or pressure wrapping around your chest.
• Stabbing - Brief, sharp pains that may feel like multiple knifelike pricks across your chest.
• Aching - A dull, throbbing discomfort gradually wearing you down.
• Burning - A intense, inflamed feeling of ribs and chest tissues on fire.

You may also experience difficulty taking full, deep breaths without hitting a wall of chest tightness. The hardness to inhale fully also leads to shortness of breath.

Other Asthma Attack Symptoms

Rarely does asthma chest pain occur in isolation. More often it strikes along with other hallmark asthma signs like:

• Audible wheezing - High-pitched whistling sound when breathing.
• Persistent dry cough - Frequent coughing jags, especially at night.
• Shortness of breath - Feeling you cannot fully catch your breath.
• Rapid, shallow breathing - Taking quicker, less satisfying breaths.

The simultaneous nature of these related asthma symptoms can help confirm chest pain comes from an asthma attack rather than other potential causes.

Asthma Chest Pain vs. Other Causes

Chest pains can arise from multiple medical conditions besides asthma. Being familiar with key distinctions between asthma chest pain and discomfort from other sources can guide next steps.

Heart Disease/Heart Attack

Chest pain is one of the most well-known signs of a potential heart attack. Behind the breastbone, such cardiac chest pain may feel like uncomfortable pressure, squeezing, fullness or ache that lasts longer than a few minutes or goes away and comes back. It may radiate to the arms, neck, jaw or back. Shortness of breath often accompanies coronary chest pain.

Compared to cardiac chest pain, asthma chest tightness more commonly stays centered along the sternum and rib cage instead of radiating outwards. Asthma breathing difficulty also produces wheezing and coughing absent with heart issues. However, when in doubt, seek immediate emergency care - better safe than sorry when hearts are involved.

Pneumonia

Pneumonia frequently causes pleuritic chest pain - sharp, knifelike discomfort when breathing deeply or coughing. This lung infection can also generate asthmatic wheezing and shortness of breath between bouts of chest pain.

Distinguishing pneumonia chest pain from asthma hinges on checking for supplemental pneumonia red flags like high fever, chills, fatigue and colored phlegm. Listen also for crackling sounds (rales) as the pneumonia-infected lungs fill with fluid and pus.

COPD

COPD (Chronic Obstructive Pulmonary Disease) describes lung damage from smoking or long-term exposure to lung irritants. The resulting airway obstruction and impaired breathing produces frequent bouts of tight chest discomfort.

Like asthma, COPD also triggers wheezing, chronic cough and shortness of breath. Separating COPD chest pain from asthma relies on confirming long-term exposure to smoke, chemicals or air pollutants. Checking oxygen blood saturation can also determine if insufficient oxygen levels indicate COPD or other lung disorders.

Pleurisy

Pleurisy refers to inflammation of the pleura - the thin lining surrounding the outside of the lungs. If this delicate membrane becomes swollen and irritated, you may feel sharp chest pains when inhaling and exhaling.

Distinguishing pleuritic chest pain requires listening for a rubbing sound (friction rub) of the inflamed pleural layers grating against each other. Pleurisy also rarely occurs with wheezing or difficulty breathing seen in asthma flare-ups.

Gastroesophageal Reflux (GERD)

When stomach acids back up into the esophagus, they can trigger painful heartburn as well as asthmatic symptoms like coughing, wheezing and chest tightness. The acid reflux and resulting airway irritation/inflammation generates chest discomfort easily mistaken for asthma chest pain.

Paying attention to accompanying reflux symptoms like bitter taste, sore throat, hoarseness and regurgitation can indicate GERD over asthma. Asthma medications also typically provide little relief for reflux-related chest symptoms.

Diagnosing Asthma as the Cause

Given all the potential lookalikes, how do you confirm asthma is genuinely causing your breathing difficulty and chest pain? Start by seeing your doctor for proper lung assessment and testing.

Physical Exam

Using a stethoscope, your physician will listen closely to your breathing patterns for telltale asthma wheezing and congestion. Checking oxygen levels can reveal lowered oxygen from asthma airway constriction.

Your doctor will palpate areas of chest discomfort to pinpoint pain locations informative of asthma. They will also examine your nose, throat and sinuses checking for drainage trickling into airways and provoking asthma flares.

Lung Function Tests

Spirometry lung testing remains the gold standard for assessing asthma severity and diagnosis. These non-invasive blow tests measure how well you inhale and exhale air.

Hallmarks of asthma like blocked airflow, poor lung expansion and breathing difficulty readily manifest on spirometry results. Documenting these asthma functional impairments supports firming up an asthma diagnosis as the source of your chest symptoms.

Asthma Control Questionnaire

Validated asthma surveys like the Asthma Control Test (ACT) quantifiably measure your recent asthma stability and control. The test scores frequency of symptoms like chest tightness over the past month that can substantiate poorly controlled asthma triggering chest pains.

Comparable asthma control questionnaires also gauge nighttime awakenings, rescue inhaler use, activity limits and overall breathlessness indicative of underlying asthma instability.

Trigger Assessment

Identifying exposures that routinely aggravate your breathing and beget chest tightness can solidify asthma as the culprit condition.

Common asthma triggers include:

• Respiratory infections
• Outdoor allergens - pollen, mold, grass
• Indoor allergens - dust mites, pet dander, mold
• Irritants - cigarette smoke, strong fumes, chemicals
• Weather changes - cold, heat, humidity
• Exercise
• Stress and emotions

Pinpointing your particular asthma triggers then avoiding subsequent exposure reduces flare-up frequency and associated chest pains.

Treatment Trial

The ultimate test to confirm asthma as the driver of chest pain is evidence that proper asthma treatment mitigates these symptoms.

Core asthma therapies like daily control inhalers (e.g. inhaled corticosteroids) combined with fast-acting bronchodilators significantly calm airway inflammation and open air flow. Reduced asthma flare-ups translate into fewer episodes of chest tightness and pain.

Track your symptom response to tailored asthma therapy over a trial period. Steady improvement endorses asthma as the correct diagnosis rather than considering other potential causes.

When To Call A Doctor

Most asthma chest discomfort responds well to at-home rescue inhaler use and resting until the flare passes. But certain scenarios demand urgent care to evaluate and treat:

• Ongoing chest pain lasting more than a few hours
• Increasing severity or persistence despite treatment
• Chest pain accompanied by dizziness, fainting or heart palpitations
• Very rapid, hard-to-catch breathing
• Wheezing loud enough to hear without stethoscope
• Feeling unable to take a full breath
• Decreased or erratic measure of oxygen saturation
• Little to no symptom relief from using rescue inhaler

Depending on exam and test findings, your doctor will decide whether to treat aggressively for an asthma flare or if further workup is needed to rule out other causes behind acute chest pain.

The Takeaway

Chest pain and breathing difficulty are miserable sensations. Asthma's airway inflammation can readily incite these frightening symptoms. But many other respiratory and heart conditions mimic an asthma flare. Trust your doctor to help correctly diagnose the trigger based on detailed history, exam, testing and treatment response. Once the true culprit is confirmed as asthma, proper management can subdue chest pains and help you breathe easier.

Disclaimer: This article is for informational purposes only and does not constitute medical advice. Always consult with a healthcare professional before starting any new treatment regimen.