Wheezing and chest tightness in asthma: causes and treatment

Chest tightness is a common symptom in people with asthma, oftentimes acting as a sign that an asthma attack is coming. It may be accompanied by other symptoms, such as shortness of breath, coughing and wheezing, i.e., a high-pitched whistling sound emitted while breathing.

In this article, we will analyze the causes of chest tightness in asthma, as well as the treatments available to patients.

1. What is asthma

First things first, let us try to understand what asthma is and how it manifests.

Asthma is a long-term inflammatory disease of the lungs that causes a patient’s airways to narrow, due to swelling or to the overproduction of mucus, thus making breathing more difficult. While it may be a relatively minor nuisance for some people, it can be particularly distressing for others, not to mention the possibility of a life-threatening asthma attack.

Common symptoms include episodes of shortness of breath, coughing, wheezing, chest tightness and trouble sleeping due to breathing difficulties. The frequency of the episodes contributes to classifying the severity of the illness.

Asthma can be diagnosed based on the following factors:

• Observation of the pattern of symptoms
• Analysis of parameters that can be collected via a spirometry test, such as forced expiratory volume in one second and peak expiratory flow rate
• A patient’s response to therapy and medication over time

Although there is currently no cure, asthma symptoms can be controlled with the proper treatment and avoiding exposure to potential environmental triggers.

1. How to recognize chest tightness

Chest tightness can feel quite distressful, as it makes it difficult to breathe in or out, and it shouldn’t be overlooked as it can be the signal of an incoming asthma attack or that other asthma symptoms are about to worsen. It usually manifests as a feeling of being constricted, as if there’s a band tightened around the torso that compels the patient to push hard in order to breathe.

Not all patients who have asthma experience chest tightness, but there is a specific type of asthma in which this symptom is frequent, i.e., Chest Tightness Variant Asthma, or CTVA.

Chest tightness can be exacerbated by physiological and environmental factors, such as:

• Respiratory infections
• Cigarette smoke
• Airborne irritants like pollen, pet dander or strong fragrances
• Smoke or chemicals
• Physical exercise

1. Medical treatments for chest tightness in asthma

Many patients who experience chest tightness find relief with other asthma treatments.

1. Bronchodilators

Bronchodilators relax muscles around the airways so that a patient can breathe more easily. There are several types of bronchodilators, the most commonly used being:

• Short-acting bronchodilator inhalers. These are also known as rescue inhalers, as they provide immediate relief when symptoms arise. Albuterol is an example of short-acting bronchodilator.
• Long-acting bronchodilators, such as tiotropium bromide. They are intended for long-term use instead of emergency treatment.

1. Corticosteroids

Corticosteroids are most usually inhaled to reduce swelling inside the airways, although oral versions are also available. Budesonide is a commonly used corticosteroid.

1. Anticholinergics

Anticholinergics prevent muscle bands from tightening around the airways, and are usually given via an inhaler or a nebulizer. They are often used in combination with inhaled corticosteroids.

All of the medication mentioned above must be prescribed by a doctor, and constant monitoring of the symptoms and their evolution is always recommended.