Your basic tests are normal
ECG normal
Chest X-ray normal
Blood work normal
SpO2 98 to 99 percent
When all these are normal, it almost always means the lungs and heart are functioning normally, and your shortness of breath is coming from non dangerous, functional causes.
Here are the most common explanations.
First. Anxiety related breathing (the most common)
Even if you do not “feel anxious”, your body can still stay in a mild fight or flight state.
This causes a feeling of
tight chest
need for deep breaths
frequent yawning
incomplete breaths
air hunger
This is the most common reason in young adults when all tests are normal.
Second. Breathing pattern disorder
Some people start taking shallow fast breaths from the upper chest instead of from the diaphragm.
This leads to
frequent sighing
feeling you cannot fill lungs properly
mild shortness of breath
This is harmless but annoying and lasts for weeks.
Third. Post viral airway sensitivity
After a mild cold, viral infection or allergy flare, your airway becomes more sensitive.
Even if your nose and throat look normal, the small airways can stay irritable for two to four weeks.
This causes mild shortness of breath without any abnormal x ray.
Fourth. Gastritis or acid reflux
Acid irritation can cause
breathing discomfort
tight feeling in upper chest
need to take deep breaths
Since you were given allergy spray but not anti reflux, this may be contributing.
Fifth. Mild allergic rhinitis or post nasal drip
When mucus trickles down the throat, it irritates the airway and makes you feel you cannot breathe fully.
This is why ENT gave nasal spray. If symptoms are only slightly improved, you may need a longer course.
Sixth. Poor sleep, stress, dehydration
These worsen breathing pattern symptoms and make you more aware of your breathing.
Very unlikely causes because your tests are normal
Heart disease
Asthma attack
Lung infection
Pulmonary embolism
These would show abnormal x ray, abnormal oxygen level, cough, fever or clear symptoms.
Next Steps
Continue nasal spray for at least two to three weeks. ENT medicines often need time.
Add an anti reflux medicine if you have acidity
Pantoprazole or Rabeprazole once daily for 10 to 14 days.
Start breathing retraining
Slow breathing
Inhale for four seconds
Exhale for six seconds
Do this for five minutes twice a day
This resets your breathing pattern.
Box breathing also helps
Inhale four seconds
Hold four seconds
Exhale four seconds
Hold four seconds
Reduce caffeine and late night heavy meals.
Light daily walking and yoga type breathing exercises help tremendously.
Health Tips
Only if you develop
worsening breathlessness
chest pain
persistent cough
fever
spO2 dropping below 95 percent
If not, this is likely functional and reversible.