instruction: hello doctor I am suffering from chest tightness and at times turns into pain I feel like I am breathing into a tight chest with constricted chest wall muscles along with shortness of breath and throat tightness the doctor said I have mild asthma and nothing he is giving me is working albuterol dulera oral prednisone I even tried herd therapy to see if it will help and it is not I am suffering a lot please help I have been tested for coronavirus three times and it came back negative my chest ray and echocardiogram has been normal as well
output: hello since when your suffering from chest tightness is it aggravating at night or early morning possible causes are like episodic asthma in which you may feel repeated episodes of chest tightness and breathing difficulty herd gastroesophageal reflux disease in which lower esophageal sphincter lead to acid reflux which may enter into to larynx cause asthmatic episode diffuse esophageal spasm this is esophageal motility disorder that lead to painful spasm of esophageal musculature on barium swallow it appears as a string of beads panic attacks lead to chest wall muscle tightness regarding this attack postnatal discharge neuromuscular disorders etc until examination is done it is difficult to say what it is so please get it done spirometry 24 hour oh monitoring esophageal manometry may useful serum ice levels barium swallow chest ray and absolute eosinophil count avoid spicy food at night elevate the head end of the bed in case of allergic asthma use tablet montelukast and levocetirizine once a day night may be useful use tablet deriphylline twice a day for five days avoid allergens that trigger the episode common allergens like household dust molds mites and pollen if no improvement please consult with your physician or pulmonologist he will examine and treat you accordingly