27 yo female having chest pains shortness of breath. all blood work normal ekg normal, chest x-ray state no evidence of cardiopulmonary disease. no soft tissue or acute osseous abnormality. cardiomediastinal silhouette in normal limits. anxiety??

There are many other medical conditions to be ruled out, including asthma, arrhythmias or musculoskeletal conditions, for example. Anxiety can always accompany or be at the root of such symptoms otherwise. The work up done is typically used to rule out life threatening conditions, specific work up may still be needed based on clinical suspicion.