Mysterious shortness of breath

Posted by gabrielm @gabrielm, May 31, 2018

I will try to make this as short as possible, but this has been going on for over 5 years, so it might be farily long. 

Beginning in summer of 2012, I began having shortness of breath (SOB) with no other symptoms. I felt a constant need to yawn, and every few breaths wouldn't satisfy the SOB. I would take a deep breath, and felt like it would get "stuck" before satisfying the air hunger feeling. About every 3-5 deep breaths would satisfy it, only for it to return a minute later. 

I got an endoscopy and other tests done, which revealed that I had some esophageal erosion due to acid reflux and a slight hiatal hernia and was diagnosed with GERD. I had always have bad heartburn, so I was prescribed with Prilosec, which I have been taking daily since them. I've tried stopping it a few times but the reflux always comes back a lot worse. 

Lung tests and x-rays were normal. Heart tests normal. Blood test revealed a slight anemia but otherwise pretty normal. 

I did some research reading forums where someone suggested taking vitamin B-12. Strangely, I took it and the SOB disappeared almost instantly. However, it only lasted a few days for it to return just as bad. I then started taking an iron supplement, which again made the SOB disappear quickly- same thing; symptom returned days later. 

After further research, I came across a breathing exercise method called the Buteyko method. Essentially you do a lot of breath holding to build up CO2 and reduce breathing as the theory is that I had chronic hyperventilation causing too much CO2 to exit my body. After applying the method and reducing my breathing, the SOB disappeared after only 2 days and I felt completely normal. I continued the method a few more days then no longer felt the need to pursue the exercises. I was normal for a whole year when the SOB once again returned with some chest tightness. I applied the method again and the symptom went away, this time with a little more effort; after about 3 weeks. I included physical exercise which also helped with my breathing. 

After that, I was normal for about 2 years. I mistakenly stopped or at least slowed down exercise and the SOB returned once again. I applied the method and began running for exercise but the SOB kept getting worse. It got so bad, I had multiple panic attacks and the feeling of completely empty lungs with the inability to satisfy it with deep breaths. I had to stop exercise altogether, apply the Buteyko method and do breathing exercises very carefully with very light and slow exercise. This helped, but it took many weeks for the SOB to improve. Then, it was almost normal when over a year ago as I was running, I couldn't get a deep breath to satisfy exercise-induced SOB. I have had SOB continuously since then (a year and a half). 

I once again started doing breathing exercises and slowly building up physical exercise, but I can't do any prolonged cardio activity because the SOB gets to a point where deep breathing will not satisfy it. While the breathing exercises have helped, they have had very little effect compared to previous efforts. It seems that every time the symptom returned, greater effort yields few results.

I suspect there is something, some underlying cause that is causing the SOB that has alluded me this entire time. 

So for the past few months to a year, the SOB is worse on some days, better on others, but never gone. There's no rhyme or reason or pattern for it. It's just there, sometimes affecting my sleep. I sometimes can't get a deep breath to satisfy it every now and then, but for the most part, a big gulp of air will satisfy it. But it returns seconds to minutes later. It's as though every breath doesn't deliver what it's supposed to, the SOB builds up, and then I have to take a big gulp of air to get rid of the feeling, pattern repeats. My breathing pattern is normal, however. I don't feel like anything physical is happening, but sometimes it feels like my airways and nostrils are slightly inflamed due to allergies, but when I don't feel inflammation the SOB is still there. 

Recent lung function tests show normal- I don't have asthma, or any other problems with my lungs. Heart tests are normal though I did have about a two week bout of heart palpitations which came and went. Haven't had any for a while- it just mysteriously started happening then stopped. Blood tests are normal, though tests always show a slight elevation of biliruben which my doc thinks is Gilbert's disease. 

I don't have sleep apnea (normal test), bloody oxygenation is normal, heart rate normal. 

I recently saw local naturopath (since mainstream docs aren't able to help) who immediately suspected a liver problem when I described my SOB, possibly liver inflammation. He used an electrodermal testing machine to test his theory which did seem to show a problem with my liver and gallbladder. He gave me digestive enzymes and a gallbladder formula to help clear a bile duct clog, thus reducing liver inflammation. He also determined with the machine that I have an egg sensitivity so I've been avoiding eggs. 

Been taking this and avoiding eggs for a couple of months, but there has been no noticeable improvement. Everything else is normal. Emotionally I'm normal- no anxiety, depression, etc. The SOB seems to be the only symptom of something, but always comes back worse, until a year and half ago when it came back and has remained since. I feel like I shouldn't have to do breath holding exercises every day just to maintain my breathing well enough to do every day things. 

Does anyone have any idea of a possible underlying cause?

@helpnywhereucan

I do get the blockage, sometimes both nostrils. As soon as I take magnesium first my sinuses unblock then the SOB diminishes substantially. I also get the uncomfortable feeling of the breath getting stuck. I'm fairly sure my issues were related to nutrient deficiencies. The body relies on certain substances to perform it's functions. If it doesn't have them, havoc ensues. For example, the mineral potassium is responsible for the contraction and expansion of the lungs (see my previous post. I do not recommend supplementing potassium unless under a doctor's care as the pills can be dangerous. But there are plenty of potassium rich foods available to us on a daily basis that we can consume with no side effects). Magnesium and potassium are closely related. If one is deficient in one, they will have issues with the other. Magnesium is also responsible for controlling both allergic and inflammatory responses. My theory is that once my magnesium dropped, the potassium did as well which set off a string of responses including poor lung expansion and contraction. Some people have said it works in reverse: you can't absorb magnesium if potassium levels are low. Once the magnesium drops the sinuses are either inflamed or over-reacting to every day substances in the air (allergies). I don't have an exact theory and didn't need one. Just wanted to feel better and by going the nutritional route I do. I can have longer stretches without a case of SOB and when it does happen, it's very manageable. Initially, I had to lurch forward or double over to breathe. One day when it first began I was driving. I almost wrecked my car.

Here are some other things I found during my search for a cure that might help someone:
In regards to c02 and overbreathing. Holding breath for a period will help balance that, so will bag breathing. For me it was a temporary fix and can also mess with your acid/base balance. If you're desperate you can try it but I wanted to get to the root cause. Slow to moderate exercise will correct c02 balances with time. I walk daily. It's recommended that you not over exercise as this causes your body to skew in favor of oxygen. If your overbreathing is related to anxiety. Magnesium will help that.

For those with trouble breathing in humidity. I had that years ago and it was completely eliminated once my magnesium levels were balanced. What felt like spasming vocal chords as well. Anxiety, gerd all gone too.

Some may have SOB due to b12 deficiencies. B12 has an effect on oxygen. Not a doctor but if it resonates with whoever is reading this post, you might want to check into that.

Vitamin C – find a vitamin that uses the buffered version or all natural form as ascorbic acid contributes to acidity in the body and that can throw your body off balance.

For some SOB could be an issue related to acid/ base balances in the body. This level needs to be tightly controlled. Do your research.

Everyone is different. You have to find what works for you. For me nutritional balancing is the route I took and I now see light at the end of the tunnel. I hardly notice it when it does happen. A good quality multivitamin that has balanced nutrients and a good diet that includes greens, fruits and greens powders, low sugar and potassium rich foods has been extremely beneficial for me. Sleep is important as well as water. Dehydration causes an electrolyte imbalance. A healthy lifestyle has been my weapon of choice. Do your research and find the will to make lifestyle changes. Hasn't been super easy but it has worked. See my previous post for more details. Hope this helps someone.

Lastly, if you're in the middle of an attack of SOB, calm down, sit and lean forward. You might need to stretch your body slightly upward. It will provide some relief.

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@helpnywhereucan Great info. Thank you!

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@ilikeearthtones

You are describing an issue I have been having EXACTLY. Yours is the only post about SOB the describes the deep breath getting "stuck" so preventing you from getting a satisfying full breath. Also, the fact that it comes and goes and is not associated with anxiety, it just happens randomly. And (although sometimes is worse than others) it is not unbearable SOB, I am able to live with it.

The weird thing is, all my tests are also normal except for a continuously slightly elevated bilirubin.

I am actually an ICU nurse so I have some knowledge about these things, and if a patient asked me about a correlation between SOB and bilirubin, I would also probably brush it off as anxiety. But since I know my symptoms are not anxiety related, I don't know what to think. It is not a normal clinical picture.

My theory right now is actually that the SOB is musculoskeletal in origin. I also have some minor upper back and rib slipping issues – and since your ribs play a crucial role in lung expansion, I thought maybe it has something to do with it. I find the most relief from the deep breaths getting "stuck" when I put athletic tape on my sides and physically pull on the tape outwards (while also leaning forward) to help my lungs expand. It's the only thing I can do to help if I want to take a deep breath.

Another (lesser, but still possible) theory is subconscious panic issues. It is possible to have physiological panic attacks even when you do not actually think you "feel" anxious. It has more to do with some kind of issue in your amygdala – making it a neuro issue. This would involve extensive neurological testing that still might not even result in a conclusive answer. (I have heard of people having this issue correlated with spontaneous anger issues as well – since the amygdala sort of controls emotions).

I have no answer at this point. But I was struck by our similar symptoms and the elevated bilirubin. The bilirubin is not something I have thought too much about.

Have you ever had any back/rib/sternal pain? Or anger problems?

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@ilikeearthtones My bilirubin levels are normal at times, but I have something called Gilbert's Syndrom, which is a minor problem with how the liver processes bilirubin. But it's a non-issue and my doctor couldn't think of any correlation with that and SOB. Your theories seem sound, though with any of these theories there seems to be no obvious cause or reasons for why this is happening. I personally have never had back or rib pain, nor anger problems or anxiety.

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I came across this thread and I am suffering from the same thing. I have to yawn in order to take a deep breath. 2 times out 10 I am able to get a satisfied deep breath, the rest it feels like my air gets stuck on my chest and then I get frustrated and panic. I start overthinking and then I think I wont be able to take my next breath. I try to swallow and even that feels like I wont be able to do. The fear intensifies and I start crying. I work out 6 days out of the week and while walking I am trying to catch my breath, while lifting I tend to forget about it a bit until I rest between sets. At nights it gets worst, I get anxiety all over my body and it takes me forever to fall asleep- I have no idea when I fall asleep. My husband tells me I am breathing fine while asleep. I do wake up in the middle of the night and stress about it. I am so frustrated with this feelings and emotions. I have had them on and off for a long time but for the past two weeks its everyday all day. I have made a doctors appointment for tomorrow and will see what he tells me. Reading all of your comments makes me feel like I am not going crazy and I am not the only one suffering with this.

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@star_ruby3

I came across this thread and I am suffering from the same thing. I have to yawn in order to take a deep breath. 2 times out 10 I am able to get a satisfied deep breath, the rest it feels like my air gets stuck on my chest and then I get frustrated and panic. I start overthinking and then I think I wont be able to take my next breath. I try to swallow and even that feels like I wont be able to do. The fear intensifies and I start crying. I work out 6 days out of the week and while walking I am trying to catch my breath, while lifting I tend to forget about it a bit until I rest between sets. At nights it gets worst, I get anxiety all over my body and it takes me forever to fall asleep- I have no idea when I fall asleep. My husband tells me I am breathing fine while asleep. I do wake up in the middle of the night and stress about it. I am so frustrated with this feelings and emotions. I have had them on and off for a long time but for the past two weeks its everyday all day. I have made a doctors appointment for tomorrow and will see what he tells me. Reading all of your comments makes me feel like I am not going crazy and I am not the only one suffering with this.

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@star_ruby3
I have the exact thing going on and the past month it has consumed my life.. i get panic attacks beczuse of it, Nd been to the er 2x just for them to say everything is fine…. my doctor is telling me its stress. I dont buy it. He told me to start taking zoloft, but i have had bad experiences with those meds in the past. I decided to try benedryl….. it got better after i took a few doses. Not sure if that was a coincidence or really an allergy there. I read and it says benedryl also helps stress too. Maybe try taking benedryl!

Liked by star_ruby3

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@aea1205

@star_ruby3
I have the exact thing going on and the past month it has consumed my life.. i get panic attacks beczuse of it, Nd been to the er 2x just for them to say everything is fine…. my doctor is telling me its stress. I dont buy it. He told me to start taking zoloft, but i have had bad experiences with those meds in the past. I decided to try benedryl….. it got better after i took a few doses. Not sure if that was a coincidence or really an allergy there. I read and it says benedryl also helps stress too. Maybe try taking benedryl!

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Thank you for replying. I don't want to be on meds as trials and see if it will fix it. I do have allergies but maybe I need to figure out how to run an allergy test and see if what I am consuming is making this worst.

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@star_ruby3

I came across this thread and I am suffering from the same thing. I have to yawn in order to take a deep breath. 2 times out 10 I am able to get a satisfied deep breath, the rest it feels like my air gets stuck on my chest and then I get frustrated and panic. I start overthinking and then I think I wont be able to take my next breath. I try to swallow and even that feels like I wont be able to do. The fear intensifies and I start crying. I work out 6 days out of the week and while walking I am trying to catch my breath, while lifting I tend to forget about it a bit until I rest between sets. At nights it gets worst, I get anxiety all over my body and it takes me forever to fall asleep- I have no idea when I fall asleep. My husband tells me I am breathing fine while asleep. I do wake up in the middle of the night and stress about it. I am so frustrated with this feelings and emotions. I have had them on and off for a long time but for the past two weeks its everyday all day. I have made a doctors appointment for tomorrow and will see what he tells me. Reading all of your comments makes me feel like I am not going crazy and I am not the only one suffering with this.

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Hi @star_ruby3 you are certainly not alone! Keep us updated and let us know what the doctor says. Get every test that you can to rule out as much as you can. How long have you had this? Do you have any GI issues; heartburn, GERD, indigestion, etc.? Are you allergies seasonal or chronic? Maybe if enough people have similar issues, there might be a link. I haven't found one yet, but still always looking.

To cope with it in the meantime, when you feel like you can't get a deep breath, try to relax and calm down as much as possible. I know it's hard especially when it's bad, but tell yourself that you're not going to die and that you'll be fine. Another coping strategy is to learn Buteyko breathing method. That has helped me a great deal and it helps manage my breathing today.

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@windwalker

hello @jillian22 Yes, having SOB is frightening. I had an episode of SOB so bad that it caused an anxiety panic attack. I thought I would die, literally. Are coughing and producing phlegm as well?

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No, no coughing or phlegm. Just sob. It ended up causing a panic attack and I wound up in the hospital. Which is now leading to doctor appointment after appointment and so far everything is coming back okay. I see a pulmonologist in two weeks but the chest x-ray and cat scan at the hospital came back clean. The cardiologist I see doesn't think it's related to my heart. Which makes everything more frustrating

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@burrkay

@jillian22 – we are here for you!
Let us know how we can help.

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Thank you. It's a wonderful feeling to know there's support out there of people who are experiencing a similar thing

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@rosemarya

Welcome to Mayo Connect, @jillian22, @ilikeearthtones, @saigurucharan, @joedelko, @helpnywhereucan. I am visiting this discussion briefly. Like you, I joined Connect because I was looking for support when I felt alone with my own health conditions. I believe that you will find support and comfort here.

As a mentor, I am happy to help you get started and I want to invite you to know that you are welcome to join in any discussion with your own questions and experiences. It is by sharinig our experiences that we find and share support with other patients who are like us.

I If you want to know more about Connect, and how it works, I am sharing this link – https://connect.mayoclinic.org/page/about-connect/

Jillian22, What kind of symptoms are you currently experiencing? As @burrkay wrote, "We are here for you".

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I have the sob and I just feel like when I'm breathing it's not going into my lungs. I even wake up randomly throughout the night feeling like I'm not breathing. My boyfriend said when it happens that I am breathing but I make this gasp as I wake up almost like a shocked or scared sound. There's no coughing or phlegm being produced. I ended up in the hospital for it and everything came back good. I've seen a cardiologist and he doesnt think its related to my heart. Next step is a pulmonologist.

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@jillian22

I have the sob and I just feel like when I'm breathing it's not going into my lungs. I even wake up randomly throughout the night feeling like I'm not breathing. My boyfriend said when it happens that I am breathing but I make this gasp as I wake up almost like a shocked or scared sound. There's no coughing or phlegm being produced. I ended up in the hospital for it and everything came back good. I've seen a cardiologist and he doesnt think its related to my heart. Next step is a pulmonologist.

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@jillian22, Did this come on rather suddenly? I ask that because of my own experience. My background: I am a liver/kidney transplant recipient and I take immunosuppressant medications for 10 years. A couple of years ago, one of those meds, prednisone, was discontinued and that is when I began to experience my SOB.
I have always struggled with uphill hiking, and blamed it on not training enough. However, I had been doing real well until the prednisone was lowered. (In hindsight, the belief is that the prednisone had been masking my exercised induced asthma and when it came back it hit me particularly hard) We were hiking and I couldn't catch my breath, even walking was strenuous and I needed frequent sit-down breaks. I made an appointment with my PCP and saw him as soon as we returned home. My PCP acted quickly and arranged me to see pulminologist and cardiologist. Lungs and heart checked out perfectly. The pulmpnologist was able to narrow my problem to being exercise induced asthma – I am not suggestion that this is what you are expereincing, however, before he helped me get it under control, I was experiencing a tightness in my chest and could not get enough air into my lungs. https://www.mayoclinic.org/diseases-conditions/exercise-induced-asthma/symptoms-causes/syc-20372300

Now back to my original question-Have you made any recent changes to your environment (new location, new bedding or furniture, medications, detergents)? My symptoms are triggered by heat and humidity, and the pollen and grass.
I know that you are afraid. I hope you can get some answers soon. When do you see the pulminologist?

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Hello all. I just wanted to check in. I recently went to an allergy doctor and the blood test showed that I do not have an abnormal reaction to allergens except dust mites. I am scheduled to get a skin test to rule out other allergies. I asked about hyperventilation syndrome as the symptoms track well with what I have and he said there is a good possibility, but I should consult with a primary care doctor or possibly a psychiatrist as it is usually anxiety related. He also said that if HVS is it then it probably has nothing to do with the dust allergy. I have noticed that when I exercise it goes away and when my mind is focused on things it is less common. This makes me think that I am over breathing and my CO2 may be low. This can lead to vasoconstriction which could possibly give an explanation for the heavy pulse I feel in my forehead and nose. I will also look into my nutrition and vitamin / mineral levels. By the way I am a 24 y.o. male who drinks alcohol on occasion and has never smoked.

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@rosemarya

@jillian22, Did this come on rather suddenly? I ask that because of my own experience. My background: I am a liver/kidney transplant recipient and I take immunosuppressant medications for 10 years. A couple of years ago, one of those meds, prednisone, was discontinued and that is when I began to experience my SOB.
I have always struggled with uphill hiking, and blamed it on not training enough. However, I had been doing real well until the prednisone was lowered. (In hindsight, the belief is that the prednisone had been masking my exercised induced asthma and when it came back it hit me particularly hard) We were hiking and I couldn't catch my breath, even walking was strenuous and I needed frequent sit-down breaks. I made an appointment with my PCP and saw him as soon as we returned home. My PCP acted quickly and arranged me to see pulminologist and cardiologist. Lungs and heart checked out perfectly. The pulmpnologist was able to narrow my problem to being exercise induced asthma – I am not suggestion that this is what you are expereincing, however, before he helped me get it under control, I was experiencing a tightness in my chest and could not get enough air into my lungs. https://www.mayoclinic.org/diseases-conditions/exercise-induced-asthma/symptoms-causes/syc-20372300

Now back to my original question-Have you made any recent changes to your environment (new location, new bedding or furniture, medications, detergents)? My symptoms are triggered by heat and humidity, and the pollen and grass.
I know that you are afraid. I hope you can get some answers soon. When do you see the pulminologist?

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There's nothing that's standing out as different. It seemed to be pretty sudden. I do have awful seasonal allergies and tons of allergies to medicines and I live in south florida where heat and humidity are year round! I'm still able to walk quite a bit without getting out of breath and I have it even when I'm having a lazy day. I was checked for asthma by my PCP and they ruled that out. I see the pulmonologist on the 29th so in two weeks. I also go for a stress test with my cardiologist tomorrow just to make sure.

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Have you had an echocardiogram as part of your heart workup? An echo can show possible causes for SOB. One thing it sometimes shows is an indication of possible pulmonary hypertension. Pulmonary hypertension is difficult to diagnose because symptoms are so similar to so many things and because most people have one or more of those other things. Pulmonary hypertension is high blood pressure in the lungs. It is not the same thing as high blood pressure in the arm. Pulmonary hypertension has 5 types – the first of which is the worst; the last four are caused by something else (heart disease is most common cause). The only way to definitely diagnose or rule out pulmonary hypertension is by having a right heart catheterization. If you have PH doctors will treat the underlying cause if there is one, or the PH directly if appropriate. But the heart echo is a good screening tool to see if the right heart cath is even needed. It is non-invasive, quick, and easy.

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@kakas

Have you had an echocardiogram as part of your heart workup? An echo can show possible causes for SOB. One thing it sometimes shows is an indication of possible pulmonary hypertension. Pulmonary hypertension is difficult to diagnose because symptoms are so similar to so many things and because most people have one or more of those other things. Pulmonary hypertension is high blood pressure in the lungs. It is not the same thing as high blood pressure in the arm. Pulmonary hypertension has 5 types – the first of which is the worst; the last four are caused by something else (heart disease is most common cause). The only way to definitely diagnose or rule out pulmonary hypertension is by having a right heart catheterization. If you have PH doctors will treat the underlying cause if there is one, or the PH directly if appropriate. But the heart echo is a good screening tool to see if the right heart cath is even needed. It is non-invasive, quick, and easy.

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I did have an echocardiogram done. The cardiologist said he saw nothing that could concern him and that everything looks healthy and doing what it should.

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@kakas

Have you had an echocardiogram as part of your heart workup? An echo can show possible causes for SOB. One thing it sometimes shows is an indication of possible pulmonary hypertension. Pulmonary hypertension is difficult to diagnose because symptoms are so similar to so many things and because most people have one or more of those other things. Pulmonary hypertension is high blood pressure in the lungs. It is not the same thing as high blood pressure in the arm. Pulmonary hypertension has 5 types – the first of which is the worst; the last four are caused by something else (heart disease is most common cause). The only way to definitely diagnose or rule out pulmonary hypertension is by having a right heart catheterization. If you have PH doctors will treat the underlying cause if there is one, or the PH directly if appropriate. But the heart echo is a good screening tool to see if the right heart cath is even needed. It is non-invasive, quick, and easy.

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I had echo and stress test done nothing concerning also PFT but sometimes i wake up just after falling asleep with feeling as if heart is not pumping properly with chest pressure and which creates urge to take deep breaths..wondering if anyone has this issue and how they coped . Thx

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