My daughter is having trouble getting a problem she has diagnosed. For the past 5 weeks, she had extreme chest pain/pressure/tightness and dyspnea with any exertion or talking. There is no cough. She has had 3 chest x-rays that are clear. Rheumatologic studies have been normal. D-Dimer is normal. Inflammatory markers are normal. We are awaiting results on an echocardiogram. Symptoms started a few days after she developed a sinus infection, which was treated with antibiotics and the sinus infection cleared rapidly, but this chest pain and dyspnea have not only not gone away, but have increased. Any ideas what we should do next to diagnose and treat this, short of heading to Mayo? We are frustrated at this point with lack diagnosis and treatment. To date, she has been tried on two courses of steriods and ibuprofen 800 mg tid for the first 3 weeks, now on indomethacin and tramadol the past week and a half. None of it is helping and she is getting weaker by the day. She went to the ER on Friday and they did a CXR and blood work and found nothing. She is unable to work and has 2 little boys to take care of. She s 30 years old. Help us with ideas, please, on what to do next?