Hello, thanks for using Healthcaremagic. I had gone through all the data you had posted. I can understand the pain you are going through I will try to be helpful in possible manner. coming to the question. patient had bypass surgery 1999 means he had an heart attack. when we develop heart attack some part our heart muscle loses contraction so that the ejection fraction may be decreased. we go for bypass when more that one vessel is involved means more chance that heart contraction power is not up to the mark. kindly update us with the 2D echo report so that we can comment more clearly. so if the ejection fraction is decreased we develop effort intolerance. so as we increase effort we get breathlessness. you have not mentioned whether patient has hypertension or diabetes. if he has hypertension the description of pain in between shoulder blades matches with AORTIC DISSECTION and it may present with breathlessness , on clinical examination there will be difference in blood pressure between both arma is one of the sign.suspicion is required to diagnose the condition and even an expert echo tech may miss it. to diagnose or rule out this we need to do CT angiography or MR angiography. or the failing heart by itself will produce breathlessness on walking so kindly update us with 2D echo, chest x ray and all other reports u have .so that I can tell more about the condition hope this helps...