Can asthma present itself as dyspnea when speaking?


Q: Hi and happy new year. Been suffering from chronic dyspnea for a couple months. Been to an endocrinologist, cardiologist and now neumonologist, who believes it could be asthma/broncospasm due to my history of allergic rhinitis, eczema (pompholyx) and slightly elevated eosinophils. I'm confused because I thought asthma presented itself as an obstruction (I basically get breathless when I speak and sometimes at rest as well, but there's no obstruction). Do you agree that it could be asthma? what studies would you recommend if I were your patient?

Symptoms:  Dyspnea when speaking, sometimes at rest, chronic. Speaking causes breathlessness and dizziness. Anxiety probably makes it worse. Used to get breathless when reading aloud as a child but family didn't think much of it. I'm now 34 and it's worse. I seem to be in good shape/strong except for the breathlessness which limits how active I can be.

A:   Hhello,
Thanks for the query
It is indeed possible to have dyspnea due to asthma, considering a history of allergic rhinitis and eczema. If you were to be my patient I would have advised you for an ECG, pulmonary finction tests, ECHO of the heart , absolute eosinophilic counts , allergen identification tests, immunoglobulin tests, check on the thyroid levels, blood sugars and a lipid profile as well. Since you have met a cardiologist and other specialist I am of the opinion that the doctors would have ruled out all the other problems before coming to a conclusion that asthma is the reason for your symptoms. Sometimes it even worsens with anxiety. You may use inhalers twice a day before you start your day and at night, this has to be continued for 3 months,
Also try yoga and deep breathing exercises, they reduce dyspnea,do not attempt cardio without doctor's opinion.Avoid all the allergens which trigger a wheeze. Rule out gastritis as well.
Hope this helps

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