When should you see a lung specialist?
Most chest symptoms settle on their own. These are the ones that should not — and the tests a pulmonologist uses to find the cause instead of guessing at it.
See a doctor the same day if you have
- Coughing up blood, even a small streak
- Breathlessness that comes on suddenly or at rest
- Chest pain with breathing, along with fever
- Unexplained weight loss with a long-standing cough
- Lips or fingertips turning bluish
For anything sudden or severe, go to the nearest emergency department rather than waiting for a clinic appointment.
Six symptoms worth a specialist opinion
A cough lasting more than 3 weeks
Most viral coughs settle within 2–3 weeks. A cough beyond that — especially with phlegm, blood, fever or weight loss — needs a chest examination, a chest X-ray and often spirometry. In India, tuberculosis, post-infectious airway inflammation, asthma, acid reflux and medication side effects are all common causes, and each is treated very differently.
Shortness of breath on everyday activity
If climbing one flight of stairs, walking to the gate or carrying groceries now leaves you breathless when it did not a year ago, that change matters. Lung function testing (PFT) measures whether the airways are obstructed, whether the lungs are stiff, and how much reverses with an inhaler — findings you cannot get from an X-ray alone.
Wheezing, chest tightness or night-time symptoms
Waking at 3–4 AM coughing or wheezing, or tightness triggered by dust, cold air, smoke or exercise, points strongly to asthma. Asthma is very treatable, but only once it is confirmed objectively and the inhaler technique is corrected — a large share of 'uncontrolled asthma' is simply incorrect device use.
Loud snoring with daytime sleepiness
Snoring with witnessed pauses in breathing, morning headaches, unrefreshing sleep or dozing off during the day suggests obstructive sleep apnea. Untreated, it raises blood pressure, blood sugar and cardiac risk. A sleep study — at a lab or at home — confirms it.
Repeated chest infections
Two or more courses of antibiotics for the chest in a year is not normal. It may indicate underlying COPD, bronchiectasis, uncontrolled asthma, aspiration or an immune problem, and it warrants imaging plus lung function testing rather than another antibiotic.
An abnormal chest X-ray or CT report
A nodule, patch, shadow or 'ILD pattern' seen on scanning needs interpretation in the context of your history and, sometimes, a bronchoscopy or radial EBUS sampling. A pulmonologist decides what needs sampling now, what needs interval follow-up and what needs nothing at all.
Others who benefit from a check
- Current or ex-smokers over 40, even without symptoms
- Long-term exposure to biomass smoke, dust, cotton fibre, silica or fumes at work
- Anyone told they have 'allergic bronchitis' for years without a spirometry test
- Family members of a patient diagnosed with tuberculosis
- Before certain surgeries, when anaesthetists request a lung function assessment
What happens at the consultation
A detailed history and chest examination come first. Depending on what they show, testing may include spirometry with reversibility, oxygen saturation at rest and on walking, a chest X-ray or CT review, allergy assessment, a sleep study, or bronchoscopy with radial EBUS sampling when imaging shows a lesion that needs a diagnosis. You leave with a written diagnosis, the reasoning behind it, and a plan you can follow at home.
Recognise your symptoms here?
Book a consultation with Dr. Arun Gangadhar at Lung Care, RS Puram, Coimbatore — or connect by video if you are outside the city.