Please help. I'm a 35 yr old male with no particular medical history.....About 3 weeks ago I began to have some shortness of breath (at rest, winded while talked, as well as winded while physically active all the same). Then, several days later, I started feeling like I was "coming down with" a flu or cold, but no fever or cough or stuffy head is developing....
I more or less feel like you feel during the hours before the onset of a fever related to a flu......fatigued, light headed, short on breath, slightly swollen neck glands, unusually sleepy, etc.
However, again, nothing is actually developing fully and I have felt this way every day for 3 weeks. No fever, no cough, no sneezing....maybe a VERY slight sinus pressure on and off with a VERY slightly runny nose, but it's barely noticeable...
I have had...a chest X-ray, CBC, BMP, D-Dimer, and TSH, as well as a normal physical exam with normal o2 and normal lung and heart sounds.
Please comment on where you'd go next? I get the sense from my doctor I should just keep waiting it out, but I don't know? This is a very strange thing that is happening to me, nothing like it has ever happened before...it's like, I'm sick...yet, I'm not, at the same time.
The primary symptom that has characterized your illness has been shortness of breath. Having had no fever is important as it strongly suggests that infection is not the problem.
The overwhelming majority of episodes of shortness of breath are on the basis of heart disease and diseases of the respiratory tract (from the nose to the lungs) and with a normal chest X-ray and normal physical exam, diseases to be considered are significantly limited to diseases of the blood vessels (including inflammation and/clots to the lungs/pulmonary emboli) and, perhaps diseases of the small airways (for example bronchiolitis.
A negative D-dimer strongly argues against the diagnosis of pulmonary embolism and you have no other symptoms of bronchiolitis and no physical findings or X-ray changes of interstitial lung disease.
The studies you have had do not rule out a cardiomyopathy or disease of the membrane that encases the heart (pericarditis), either of which can occur with a normal sized heart on chest X-ray. You should ask your doctors about these possibilities and whether further testing of heart function should be considered.
After exclusion of heart and lung disease, the 3rd disease associated with shortness of breath is anxiety with or without what is called panic disorder, with or without hyperventilation (that is, inappropriate over-ventilation). You might also want to discuss this with your doctors.
Finally, in some disease states, tests that were negative/normal at the outset may become positive/abnormal after several weeks. Given that, you might also want to ask your doctors if it might be revealing to repeat one or more of the initial tests.
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