Q. Can the constant feeling of tightness in the chest be COPD?

Hello doctor,

I am frustrated with my asthma. I am 26 years old and developed asthma two years ago. It went untreated for almost a year, then I started taking Qvar (two puffs twice a day) and moved to Symbicort. I am currently on 180/4.5 of Symbicort, two puffs twice a day. While it helped a lot, I still have near-constant chest tightness. I was worried that it might have damaged my lungs or had done remodeling, but I underwent high resolution computed tomography (HRCT), which found no abnormalities. My pulmonary function test (PFT) results are as follows: Pre-bronchodilator forced vital capcity (FVC): 6.18 L (116 % predicted), forced expiratory volume (FEV)1: 4.53 L (102 % predicted), forced expiratory flow (FEF)25: 75 3.45 L (75 % predicted), Ratio: 73 % (88 % predicted), resistance airway (RAW): 2.27 (134 % predicted), specific airway conductance (sGAW): 0.10 (38 % predicted), Post-bronchodilator forced vital capacity (FVC): 6.34 L (119 % predicted) change is of 3 %, forced expiratory volume (FEV1): 4.69 L (106 % predicted) change is of 4 %, FEF25-75: 3.79 L (83 % predicted) change is of 10 %, Ratio: 74 % (89 % predicted) change is of 1 %. I was diagnosed with mild persistent asthma. My question is, how can I have pretty much normal spirometry with normal HRCT but still have these daily annoying symptoms. Is it possible this tightness is my new normal? I am desperately trying to get back to how I was before I developed asthma. I would appreciate any suggestions. I am thinking of Montelukast and asking to switch to Trelegy. The cardiac workup was normal (Echo and ECG).

Hello doctor,

I want to know what you think of the fact that this bronchoconstriction is daily and persistent. Is this more in line with chronic obstructive pulmonary disease (COPD)?