Brief Answer:
Very likely they are no serious but panic attacks- advises given

Detailed Answer:
Hello,
Thank you for asking at healthcaremagic.

I carefully read your question and understand your concern.

Most of the times the shortness of breath is very scary to the patients and the first things that come to mind is the heart and lungs as the cause of it. In some patients this is the case, especially in those with chronic conditions like hypertension, diabetes, age over 40, strong family history for sudden deaths in young age due to heart attacks, sport players that exercise and overexercise their heart, and very important those who use cocaine.

You are a young male and if you have been healthy so far with no chronic conditions, no family history of sudden unexplained deaths or deaths due to heart attacks, if you do not overexercise and do not use cocaine than very likely the most common cause in your case is anxiety, we call these panic attacks. Generally they happen in the evenings or night and last few minutes to up to one hour and quiet down and than an episode might start in a while. Some patients might have them very often and have the impression it is there all the time.

Having this diagnosis while you fear more serious conditions sometimes is unacceptable to patients but this is the most common cause of your symptoms in your age and is very treatable condition.
It does not generally cause serious consequences to your health but might cause a lot of discomfort.

Ways to treat it is:
1. realization that this is not dangerous and is self limiting, most of the patients are enough with this
2. relaxation techniques- breathing slow or breathing in a paper bag, being in quiet places when it happens, etc
3. having a good balanced life: activities, rest and eating
4. avoid smoking, alcohol and coffee (coffee and cola and other stimulants might trigger those episodes and make them worse)
5. Going for walks, taking with a trusted loved person and sharing regularly
6. medications in the group of SSRI are the first choice if your symptoms have been there for longer than 2 weeks and affect your quality of life. They can be taken daily without the risk of addiction and have a very good effect. The sleeping pill might help for the moment and has the addiction risks so it is not recommended to be taken often of for long times.
7. basic work up if you want to be in peace of mind would be CBC (for anemia), ECG (for the heart rhythm), FBS (for diabetes), TSH (for thyroid problems), rarely a CXR (x-ray film of your chest to check the lungs)- you might discuss those with your doctor and see the need for these.

I hope this is helpful to you and answers to your questions but please feel free to write me in case anymore clarification is needed on this.

Kind regards,

Antoneta Zotaj, MD

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Brief Answer:
Explanations on the diagnosis mentioned and some advises

Detailed Answer:
Hello,
Thank you for writing this followup reply.

I read carefully through your message again. Adenoids do not generally cause episodic shortness of breath during the day but mostly constant shortness of breath when you are laying down.
You might have also some symptoms of upper airway blockage possibly due to the nostrils affected by some kind or allergic reaction also (allergic rhinitis)- this is very common and might add to the blockage from the adenoids but these should not cause you to have blurry vision and feeling like you are going to faint.

Blurry vision and feeling like going to faint mostly happen due to breathing changes during a panic attack and the oxygen levels being altered due to that- it is not dangerous but might cause someone to faint due to this.

Having phlegm in the lungs is a very unspecific term, did your doctors tell you you have infection in the lungs? It is unlikely to have lung infection for so long, it either gets healed by the body or you get progressively worse till being hospitalised within a couple of weeks. I would not also expect a young male to have phlegm in the lungs outside of lung infection as this would mostly happen in patients with chronic bronchitis which happens in patients that have 20-30 years of smoking history.

So to conclude:
- adenoids and possibly some allergic rhinitis (one of your nostrils feels blocked) might cause some upper airway blockage especially at night but unlikely to cause shortness of breath with blurry vision and nearly fainting episodes
- it is unlikely to have phlegm in the lungs for a long time in a young male. Short time of phlegm in the lungs happens with lung infection (pneumonia) but that does not go beyond a couple of weeks. Cough, fever, chest pain and fatigue would dominate in the case of pneumonia. Chronic bronchitis that would cause phlegm in the lungs for a long time does not seem the case either (happens after 20-30 years of smoking)

I understand your concern with the possible cause of your symptoms as actually there is a huge range of diagnosis that can cause shortness of breath and is very worrisome to the patient. By my experience almost 90% of young patients with your symptoms have panic attack as the cause of them and typically visit different doctors and get different opinions and more confused.

If you are worried of the lungs, a chest xray is an easy test to rule it out. As for the adenoids it is unlikely to be the cause and I would not consider anything for those (generally they get smaller with age and no need to do anything with them unless they cause a lot of sleep issues with snoring, sleep apnea and daytime sleepiness- which you did not have)

Please let me know if anymore questions related to this or more clarifications are needed. I would be very pleased to address your concerns.

Kind regards,

Antoneta Zotaj, MD

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