Question: I have had shortness of breath for several months and severe hoarseness. A stress test showed no problems, so I was sent to a pulmonary specialist and further testing did not reveal any problems. I also saw an ENT specialist whose examination revealed a cyst just above a vocal cord. It was removed by surgery, was benign, and the hoarseness went away. However, there is still a problem with shortness of breath. What should I do next?

Dr. Hibberd's Answer:

Shortness of breath can be caused by many conditions. I will assume your heart doctor is comfortable that your heart function is sufficient to NOT cause this symptom. If you are not sure, re-address this with your cardiologist now that your lung screening is clear. I assume your pulmonary specialist is satisfied your lungs are not causing shortness of breath.
Having cleared these two hurdles, you now need to address your general conditioning. You have made no mention of your age, weight, exercise, past health, smoking habits, or the circumstances surrounding your sensation of shortness of breath. Blood loss, anemia, embolism, chronic illness and hemoglobin disorders all affect the oxygen carrying capacity of your blood. Some medications, drugs and toxins interfere with the release of oxygen tissues resulting in shortness of breath. Do you work with pesticides, fertilizers or chemicals? Do you work at altitude? Do you scuba or dive? Many hormonal and electrolyte disorders may also be associated with shortness of breath. Once all these areas have been explored, we will assume you have poor conditioning and recommend appropriate treatment. Shortness of breath is one of those symptoms that you should be seeking immediate consultation for. Cardiac and lung clearance alone are not sufficient. Avoid self-diagnosis with this one. I advise you to consult further with your primary physician.