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Dr. Phil, MD
Dr. Phil, MD, Medical Doctor
Category: Cardiology
Satisfied Customers: 55770
Experience:  Cardiology Expert
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I am a 22 year old male with no known chronic illnesses

Customer Question

I am a 22 year old male with no known chronic illnesses other than GERD for which I take a PPI. I take no other medications. I am not overweight and consider myself to be of average fitness for my age. For at least the last few years I have been experiencing what I assume is an abnormal level of shortness of breath with only slight exertion. For example after climbing one flight of stairs I am usually out of breath at the top, and occasionally have to stop halfway up the single flight of stairs to catch my breath. My heart rate typically increases from approximately 75 at rest in a standing position at the bottom of the stairs to approximately 105 a few seconds after reaching the top. I also experience SOB with activities like making my bed or getting down to tie my shoes, but do not have SOB with walking quickly or while sitting. I have had an EKG, ECHO, stress EKG, and cardiac MRI that have all been normal except for: mitral valve prolapse (no mitral regurgitation, trace tricuspid regurgitation, trace pulmonary insufficiency), IRBBB, split S2, and sometimes inverted T waves both at rest and during exertion. I have occasional runs of 2-4 PVCs but they only occur once or twice per hour which I understand to be well within the normal range. I realize that these minor abnormalities rarely represent any serious condition, yet something must be causing my SOB. PFTs are normal. SpO2 is normal. No chest pain except a single occurrence 1 year ago which went away after 4 hours. What is your medical opinion on the most likely cause of my SOB? Could it be that the MVP alone is causing my SOB? Could it be that I have an ASD that was not detected by the ECHO or MRI? (ECHO was without bubbles and MRI was without contrast). I do not feel like I have any life-threatening condition but it has been an annoyance that interferes with everyday tasks and at the very least I would like to know what the cause is. Please let me know if you need any additional information from me.
Submitted: 1 year ago.
Category: Cardiology
Expert:  Dr. Phil, MD replied 1 year ago.

What about anxiety as a cause?

Customer: replied 1 year ago.
It is my understanding that anxiety would cause SOB that improves upon exertion, and not cause SOB that is ONLY present upon exertion, is this not correct?
Expert:  Dr. Phil, MD replied 1 year ago.

No that is not correct. In fact, just awareness of breathing can feel like shortness of breath. Anxiety is a common trigger for that

Customer: replied 1 year ago.
Thank you for the information, I understand. But I do not think anxiety as a cause of SOB fits with my symptoms. My SOB is not triggered by stressful events or feelings, but only by physical actions such as climbing stairs. Wouldn't anxiety also cause episodes of SOB at rest?
Expert:  Dr. Phil, MD replied 1 year ago.

It could yes but perhaps your anxiety is fixated on activity. If your total heart and lung workup is normal then it isn't anything physical

It must be mental

Expert:  Dr. Phil, MD replied 1 year ago.

Please don't forget a positive rating. I appreciate it. :)

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