Question: I've been admitted to the hospital after a bout in which I had great difficulty breathing. This has happened three times before, about once a year until this time. Always results in a visit to the ER.

Three weeks ago it happened and I was diagnosed with pneumonia. The pneumonia appeared to resolve, then two days ago it hit again and I returned to the emergency room.

When it happens, I really can't breath, but they give me a mist and oxygen to breath and I get relief. But I get the pleasure of at least one overnight at the hospital for observation.

This time, x-Ray and CAT scan are negative for anything including pneumonia. They've checked my heart and it is clearly not that.

What I experience feels like an air bubble. Usually starts at the top of my chest and then moves above my heart and then can move on down to the bottom of my chest cavity.

I'm at a world class hospital and they are stumped. They have done all the tests they can think of and are likely to discharge me shortly. I feel fully recovered but the attacks are scary and debilitating.

I have minor acid reflux that is triggered, rarely these days, by very strenuous exercise for which I take one tablet of OTC omeprezol each morning that has kept the problem virtually entirely in check.

I am a 65 year old male, 6'1" 185 lbs. in very good health and do rather vigorous yoga 2 to 3 times weekly. I normally have really good lungs. A regularly take 1-3 mile walks at the insistence of a small dog. My only other regular medication is Zoloft and a small dose of lithium, both for depression -- been on this regime for 20 years.

The attending here is thinking possibly esophageal spasm, but I don't has reflux or acid in throat. Sounds a little like a diaphragm spasm, but doesn't quite fit there either.

I'm looking for other possibilities. I can get in to see a top specialist here in just about anything. Any ideas what else they should be considering?