Hi, Coarse vascular marking is non specific finding and following causes ruled out. -Smoking induced - Bronchitis (viral or allergic) - Aasthma like allergic inflammation So stop smoking if habit As you are having chest pain you might have bronchitis. Your Auscultation should be done and if needed spirometry done that will be helpful in assess severity and deciding management plan. Decongestant drug like phenylephrine can be prescribed and if inflammation more than short term steroid needed If bronchitis seems bacterial then antibiotic course is prescribed If bronchoconstriction more by bronchitis than ipratropium bromide like inhaler is given. Consult pulmonologoist for examination and discuss regarding management plan with keeping my answer in mind. Hope your concern is solved. Let me know if I can assist you further. Regards, Dr. Parth Goswami