Tightness in the Chest During a Brisk Walk in Cold Weather
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QUESTION: It seemed like such a good idea. While visiting my son in
Minnesota, he invited me to take a brisk walk before washing up for supper.
The evening was cold, with snow on the ground, but good footing along the
road. We hadn’t made a half mile before I experienced a tightness in my
chest, a dry cough and wheezing. I could barely breathe. The rapid trip to
an emergency room convinced all that it wasn’t a heart attack. When I
returned home to Florida, I rushed home one evening walking further and faster
than in Minnesota, and nothing happened. There has got to be a logical
explanation. Do you know what it might be?
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ANSWER: With the data you provide, and the fact that you have been cleared of
any cardiac problems, my best guess is that you suffered an attack of exercise
induced asthma, provoked by the cold climate that seems to be the important
element in your case. It’s probably a common enough condition, and can be
diagnosed with a pulmonary function test and a better history and examination
than is available to me. The asthma-like attack is caused when the
bronchioles, or small tubes that carry the air to and from the lungs, contract
because of irritation or reaction to substances to which they are sensitive.
In the case of exercising, even a brisk walk in the snow, it is possible that
the dry air you were breathing in dehydrated the airways and caused them to
contract. When you performed the same activity in the warm and moist air of
your home town, the factors that caused the attack previously were absent, and
so no attack. Because this is but one answer to an interesting medical
situation, I strongly advise a thorough overhaul, with special attention to
your past history and the necessary tests to establish the performance
patterns of your lungs.
