How to know if it's anxiety, asthma, or sinister lung thing?

I've experienced health anxiety for about 10 years now and never really had chest pain/breathlessness with it. But then again I also haven't really ever worried about anything sinister like lung tumour or something (hence not been focused on that area). About a month or so ago I had some concerns about breast cancer (mostly unwarranted) and started focusing on pain in my left chest area and upper back/ribs (so my health anxiety had me believe I had breast cancer that had spread to my lungs as I started noticing a tightness in my chest and niggly sporadic dry cough. When the breast specialist advised he was not concerned about it from his perspective of course I was relieved, but the rib/back pain and breathlessness and dry cough has continued. So I went to GP and she said there was nothing alarming her but gave me a referral for a chest CT scan as she said there was nothing else she could do to know what was or wasn't going on in there. She also prescribed anti inflammatories for the back/rib pain. She didn't listen to my chest at all. I've had blood tests a couple of months ago which were fine and a spine MRI (for issues with numbness and tingling) but these were all fine. I do have a vague autoimmune condition (undifferentiated connective tissue disorder), so do get weird aches and pains, blotchy fingers and toes, and weird rosacea type face rash. I have had 6 CT scans over the past 10 years (on chest, bones, and abdomen - last one being chest bone scan about 18 months ago) so reluctant to have more radiation if I don't need it.

Therefore trying hard to resist the temptation to run off for this chest CT. But how else can I tell what is going on in my chest? The tightness is there constantly, whether I'm resting, exercising, if I wake up in night etc., the cough is an itchy dry cough that is more after exercise or after eating, it's not there all the time, maybe every few hours. If it was just the tightness/breathlessness I'd assume it could be anxiety related, but given the niggly cough I'm not so sure. I do have a post nasal drip as well. Not sure what else to try or do?

Im experiencing something very similar. The closest thing i can deduce as far as a diagnosis is that it’s related to either acid reflux, post nasal drip or a combination of the 2. My oesophagus feels quite irritated and tickly at times, mostly in the evening. Makes me want to cough at times. There’s alot of mucus at the back of my throat so i’m constantly throat clearing. I’d be interested to hear what your CT had revealed in regards to your symptoms.

I would suggest seeing a different GP who is aware of your HA and who has read the notes from your previous investigations.

Thanks for your replies. Going to GP tomorrow morning, same practice, but different doctor, one I’ve seen quite a lot in the past. I actually ended up in A&E last night due to a random allergic reaction to a lactase tablet (I’m lactose intolerant but don’t usually take them before dairy just chose to on this occasion). Ended up in a bad reaction and throat started closing up. Had similar symptoms to when I’ve had pancreatitis as well but eased quite quickly. Hospital did bloods just to check it wasn’t pancreatitis attack and bloods all fine. Anyway, going to GP tomorrow to get referred back to allergist/ immunologist I’ve seen in past. Need to have some more allergy tests. Not only due to last night’s episode but also because this weird breathless asthma type thing I’m having, perhaps it is allergy related as well. Will tell doctor I don’t want to run off and have CT as yet, and just need to establish if this is allergies and anxiety (the general chest stuff, not last night’s as that was definitely allergic reaction!)