Why do I randomly have shortness of breath?

Why do I get shortness of breath without any found disease?

• Hi. Almost a year ago I had an episode of Anxiety, Shortness of breath and dizziness. Went to the ER and after examination and several EKGs been diagnosed with pretty much nothing (neuro-vegetative disturbances) and prescribed to take calcium and magnesium supplements. Checked with my doc and he ran blood tests which came back normal, except for a mild Anemia (low Iron, magnesium and ionic calcium levels, not too low but near-minimum). Doc prescribed iron supplements. Gradually the sensation of not getting enough air pretty much dissapeared. During the summer I experienced a mild sinus Tachycardia (rate about 90-100) treated with Propranolol. Now my pulse is around 70 and I do not take any more pills for it - it sometimes rises especially after exercise, and doc told me I am not in the best physical condition (raises to about 90-95 for a few minutes after stopping). However, I still get a permanent feeling of Shortness of breath, not like my lung doesn't fill normally with air, more like needing a good deep yawning or like my breathing muscles are too tense and can't let me take a really deep satisfying breath - all is well until trying to inhale the last "bit" of air, when I get this sensation. Also my chest hurts, sometimes in the left area, sometimes in the right, almost always near the sternum. The chest hurts when pressed with my finger. Ribs are painful too. When I contract my chest muscles the pain increases slightly. The pain is not intense and goes away for a few days, comes back for a few days in some other area in my chest. Sometimes my ankles hurt a bit and my right hand, the small bones right near my fist. Fingers at my right hand are painful at times. These pains go away quickly when applying Ibuprofen or the like(spelled it right I hope) to the area. However they are back after some hours. I have done blood tests 3 times in the last year, went to 3 different cardiologists, had Echo of the heart, Echo of the abdomen, neurological exam, Spirometry, stress Echo,etc. etc, everything is OK. I went to the cardiologist when I was at peak with my symptoms and nothing was found I am currently taking mineral supplements and following psychological counselling since I have developed a strong fear that something is deeply wrong with me. When in session and days after I feel ok, no more symptoms. My symptoms are generally not very intense, I feel like my fear is amplifying them somehow. I am a 25 year old male, no heart disease or other medical condition, good health, good family health, not overweight, smoker (under 1 pack a day), not in best fitness (sitting job - programmer). My questions are: 1. If sometimes were wrong with my heart, would it have been diagnosed yet? 2. Need I do more investigations regarding my heart? 3. Does all this look more like a psychological condition than a physical one? 4. In a few words: how should I change my lifestyle in order to keep my heart healthy? Thank you for reading this message. Bogdan Vulcan

• Answer:

  Hello..that is probably the longest question I saw on this forum, but that is a good thing, as you've provided all the details. The bottom line is the above poster is probably right. You have had a thorough cardiac and pulmonary check ups it seems, and there were no abnoramilities. The length of the message, the fact that you've seen three cardiologists and the fact that you feel better after your sessions all point to anxiety. Your smoking may not be good for your heart and lungs, but I suspect it actually helps your anxiety. I would still advise stopping smoking, but the bottom line, step up your psychological work-up...may be a low dose SSRI (like Paxil or Celexa) would help. Work with your doctor about it and good luck. I think yo are on a good track thinking about this...