medical anomaly- symptoms but no cause

[conundrum862]

i'm a rather healthy 17 year old, a non-smoker, and have been suffering from unknown respiratory symptoms for over a year. i've been having constant shortness of breath, muscle tightness in my chest, and i can't seem to catch a full breath- which, if i do, is very painful. I've been yawning frequently as well, in my lung's dire attempts to fill themselves to maximum capacity. also, i feel a lot of pressure on or around my lower sternum.

i've been having these problems ever since i recovered from having bronchitis the spring before last. they have been progressively growing worse, to where as i was once able to shrug it off, i'm now constantly having trouble breathing. i'm not an atheletic person, and even when i do exercise there is no change in my trouble breathing. i frequently have problems when i am just sitting down.

my mother has been shrugging this off, saying that it's anxiety. however, i don't believe that i would have anxiety continuously for over a year. i was afraid i might have had a collapsed lung, or a broken rib from all the coughing, but even so, it would have healed by now.

last month i went in to see my doctor and i was told that my lungs were fine, but i was sent in for a pulmonary test for asthema. my tests came back clean, yet the problem still occurs. i haven't had any other medical problems, nor do i have any allergies. it worries me that this has been going on for so long, but it is more annoying than anything.

if you have any ideas on what this could be, other than the possibility that i could be a hypochondriac, i would be extremely thankful.

[National Jewish Health]

You have provided a good, concise description of what is troubling you.  Your problem could be asthma, despite the normal pulmonary function tests (PFTs), but chest pain or discomfort is very uncommon with asthma.  There are however many other heart and lung conditions that could account for your symptoms.  While anxiety could be contributing to your symptoms and can last for years, before your symptoms are attributed to anxiety, you should have additional tests performed to rule-out either heart or lung disease.  And, you are right is suspecting that hard coughing could damage your rib cage or sternum.  If separation of ribs or sternal fracture occurs, the symptoms might not spontaneously resolve within a year.

Unless your doctor is firmly convinced that anxiety is the problem, in which case a trial of anxiolytic medicines would be appropriate, you should have a chest x-ray, testing for clots to the lungs, also known as pulmonary emboli (PE), and testing for pulmonary hypertension, which is high blood pressure in your lungs.  Assuming the PFTs were normal, that does not eliminate the possibility that you could have serious, treatable heart or lung diseases.

I am sure that your mother means well, but your symptoms have been going on for a long time, and should not be written-off as, "just anxiety or hypochondriosis".

[conundrum862]

I went in for a regular physical last friday, and mentioned the lung problem to my doctor, because the woman who saw me before for my walk-in was a nurse practitioner. When my doctor listened to my lungs, she told me they were fine. However, she said she was hearing some abnormal sounds in my heart.

So they hooked me up to an EKG to check for any problems, but the test didn't show much. I'm scheduled to have an echocardiogram next Wednesday, but in the time being I'm rather curious to what the problem could be. I asked my anatomy teacher, who worked as a doctor for quite a few years, and she suggested that my problem is most likely Mitral Valve Prolapse. This seems likely, but are there any other possibilities to what it could be?