I’m a 24-year-old male (172 cm, around 110–115 kg) and I’ve been dealing with breathing-related symptoms for about three years. Lately I’ve become increasingly worried, especially about how my breathing feels when I’m lying down.
A big part of my anxiety comes from my family history. My father died suddenly from cardiac arrest at 59, and during the autopsy they found signs of previous heart attacks. Since then I’ve been very alert to anything that could be heart-related.
My main issue at the moment is a feeling of not getting a satisfying breath, especially when I’m lying down. This tends to happen more in the evening and sometimes after eating a larger meal. It feels like I need to take deep breaths, but they don’t feel “complete.” Despite this, I’m usually still able to fall asleep. The sensation comes and goes and is not present every day.
In addition to that, I sometimes have a sharp, localized chest pain that occurs with deep inhalation, coughing, or even laughing. It only lasts a few seconds and I can often reproduce it by pressing on a specific spot on my chest. I also notice a kind of cracking or popping sensation on the left side of my chest when I take a deep breath. Occasionally there’s a bubbling feeling as well.
I sometimes feel my heartbeat quite strongly in my chest or neck, especially when I take a deep breath or briefly hold my breath. This sensation usually goes away when I exhale.
What confuses me is that my exercise tolerance seems good. I regularly go on long bike rides (40–60 km), play sports like badminton, and do physical work like gardening. During these activities I generally don’t have breathing problems. I can get out of breath on steep climbs, but that seems normal and I recover quickly. Sometimes symptoms are even more noticeable at rest than during activity.
Other things I’ve noticed: I used to have a pulling or tingling sensation in my left arm, especially during periods of high anxiety, but that has mostly disappeared. I also have some reflux symptoms like heartburn and occasional hoarseness. There was one episode of dizziness in January that lasted a few days with some balance issues, but that resolved.
Overall, my symptoms fluctuate a lot. They are not steadily getting worse and sometimes disappear completely. They also seem to be influenced by body position, breathing, and how much attention I pay to them.
So far I’ve had several tests: a recent ECG, a 24-hour ECG in the past, and an echocardiogram, all normal. Spirometry was normal. A chest X-ray a few years ago was normal. I also had a brain MRI with contrast that was normal, and multiple ultrasounds of lymph nodes which were stable and unremarkable. Blood tests were mostly normal aside from slightly elevated cholesterol and liver values.
Doctors so far have not found any indication of heart or lung disease and think the symptoms are more functional or musculoskeletal, but I’m still worried because of my father’s history and the breathing discomfort when lying down.
My main question is whether this pattern, especially the breathing issues in the lying position, could still point toward something like heart failure, or whether the normal tests and good exercise tolerance make that unlikely.
Thanks a lot for reading.