Chest Pain/Shortness breath Symptoms; What scan would you get next?

Hello all,

I’m a 24 y/o male and would really really appreciate some input on what exam I should get next. I’ve asked the same question to my PCP and Pulmonologist but would prefer a wider array of opinions to then present to them for consideration. PLEASE, I don't mind anyone not wanting to read this much but don't jump to "Chest pain & labored breathing? Go see a doc ASAP". I can already hear someone projecting it as I click submit 😉

I’ve been experiencing sporadic shortness of breath, heart palpitations though very seldom lately and mostly just during hard workouts now, pain in left chest area upon deeper inhales and exhales, can guarantee pain upon each inhale if I’m breathing a chemical in the air like acetone or rubbing alcohol, Other chest pain that produces a pressure-pain to left of sternum during certain workouts usually more prevalent the harder the pump, more prevalent pain in lung/sternum area and breathing gets tight when just slightly dehydrated. Also sometimes feels like the left lung isn’t wanting to contract for a fulfilling breath. This next symptom hasn’t persisted lately but dealt with it for like 4 months - feeling like I sometimes can’t get a smooth food/water swallow in like it keeps allowing some down wrong tube and being a catalyst for left lung pain.

So to offer context, I don’t have a lot of money and therefore have had to do my own due diligence then bring it to my 2 doctors so we can put our heads together. I acquired my medical MJ card January 2019 and began smoking and dabbing 2-3 times daily 4-7 times a week. Developed some very bad lung and bronchial issues come November and stubbornly quit like 3-4 weeks after pain began. It got really bad with constant labored breathing unable to get a few words out between air gasps. Had sharp pain in left lung and right in symmetrical areas as well as bronchials (left bronchial and right lung pain out above bc/ it only persists on left side now).. I had even less $ then so jumped on medical recommendations for COPD patients. So lung damage is a certainty and clearly improving over time.

But that leaves the heart palps, pressured chest pain, and occasional labored breathing despite being fully hydrated up for question. Also can’t be certain that weaker contractions in left lung are lung damage or pulmonary valve related. Damage to pulmonary valve could easily lead to all symptoms. A pericardial effusion could lead to many of them. Iron overload could lead to all and I noted less symptoms after a blood drawing more than once now. I also follow a strict diet for other reasons that include organs - cow liver, kidney, and heart all with sufficient iron in them and have followed it awhile now. Or it could simply be the lung damage symptoms compounding with my back issues/scoliosis as my left rib and sternum are clearly protruding more than right side as scoliosis slowly develops and the pressured chest pain is most prominent with chest-related workouts. So many things to consider unfortunately 😕.

I’ve had an iron panel blood test and all levels are normal though I’ve seen rare cases on the internet of people with normal iron serum levels still having organ iron overload so while in the back burner, I can’t fully exclude it.

Also just had my first imaging, a CT scan w/out contrast of chest. Report said “No mediastinal, hilar or axillary lymphadenopathy. There’s a trace pericardial effusion, and there is fluid in superior pericardial recess & superior aortic recess. Limited views of the upper abdomen are unremarkable. There is a benign 1 mm subpleural nodular density in the left lower lobe (series #4, image #45). The lungs are otherwise clear. There is no pleural effusion or pneumothorax. The osseous structures are intact”

Which ultimately leads me to the question I came to ask! With all that context, what next scan should I seek to rule out as many potential causes as possible? Would a chest MRI show lungs & heart? Or would that be redundant with the CT scan for any possibility outside of heart iron overload? Any other ideas or input are also appreciated 😃. Thank you for bearing with the lengthiness!

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