2 doctors weighed in:

Any rarer causes 4 breathlessness/chest pressure when tired/sleepy? Basic tests OK (echo, spiro, CXR, TSH, CBC, sugar). Hormonal? autoimmune? brain?

2 doctors weighed in
Dr. John Chiu
Internal Medicine - Allergy & Immunology

In brief: Muscle disorder?

Since these tests didn't show evidence for lung or cardiovascular disease and your symptoms occur only when you are tired, one needs to rule out a muscle disorder such as myasthenia gravis, certain kinds of mitochrondrial abnormalities and etc.
Your best bet would be going some place like an university medical center or the Mayo Clinic.

In brief: Muscle disorder?

Since these tests didn't show evidence for lung or cardiovascular disease and your symptoms occur only when you are tired, one needs to rule out a muscle disorder such as myasthenia gravis, certain kinds of mitochrondrial abnormalities and etc.
Your best bet would be going some place like an university medical center or the Mayo Clinic.
Dr. John Chiu
Dr. John Chiu
Thank
Dr. Al Hegab
Internal Medicine - Allergy & Immunology

In brief: Common causes

Are asthma, which fit the description, and all the tests you ran would still be fine, if you have chest pain too, you need to rule out any cardiac problem as coronary spasm or insufficieny, to diagnose either you need spirometry before and after exercise or bronchodilator therapy to diagnose asthma, or cardiac stress testing for coronary insufficieny, kind of remote, treatment is within reach

In brief: Common causes

Are asthma, which fit the description, and all the tests you ran would still be fine, if you have chest pain too, you need to rule out any cardiac problem as coronary spasm or insufficieny, to diagnose either you need spirometry before and after exercise or bronchodilator therapy to diagnose asthma, or cardiac stress testing for coronary insufficieny, kind of remote, treatment is within reach
Dr. Al Hegab
Dr. Al Hegab
Thank
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