Recurrent Episodes of Breathlessness in a Young Man

A 34-year-old man presented with seven months of paroxysmal, rapid-onset throat tightness and a feeling of breathlessness.Despite three emergency department visits, he was discharged without a confirmed diagnosis.Empiric treatment for panic attacks and asthma did not prevent recurrence.Respiratory rate, oxygen saturation, chest radiography, arterial blood gas, and an electrocardiogram were normal during evaluated episodes.During a subsequent medical encounter, reframing prompted scrutiny of the initial hypotheses and ultimately led to diagnostic resolution.This case illustrates how anchoring bias can persist across encounters when an unconfirmed diagnostic label is carried forward and emphasizes the importance of iterative diagnostic testing, particularly when the treatment of the presumed diagnosis is ineffective.