Disclaimer: Written with AI / voice recording — typing is difficult because my right hand is in a splint.

AI Summary

• 30yo male, 167 cm, 82 kg. Physically active pre‑illness (~3,500–4,000 km walking/hiking and ~5,000 km cycling in 2025).
• Symptoms began on 20/03/2026 after an 80 km bike ride with extreme exhaustion and heavy/rapid heartbeat. Progressive post‑exertional exhaustion since.
• Marked fatigue after light–moderate activity (9 km commute, carrying bike up 3 flights, 7–15 km hikes); requires 20–60+ minutes rest to recover. New/worsening chest pain and heavy breathing on exertion. Fluctuating course.
• Probable recent mononucleosis on bloods (~2 weeks after onset). Multiple ECGs normal.
• Recent bicycle accident (concussion, fractured thumb/wrist/ribs) — did not significantly change baseline exhaustion.
• Diagnosed chronic migraine; prophylaxis trimipramine (off‑label); acute sumatriptan.
• New skin/eye findings: persistent bluish‑reddish bags under eyes and slight yellow tinge around eyes since holiday.
• GP advised rest; limited improvement. Concerned symptoms are being attributed to psychological causes but suspect organic cause.
• Current concern: progressive exercise intolerance and worsening chest pain since yesterday.

30yo male, 167 cm, 82 kg.

I was usually very physically active — around 3,500–4,000 km walking/hiking and ~5,000 km cycling in 2025. I’ve never experienced anything like this before.

Symptoms began on 20/03/2026 after an 80 km bike ride when I became extremely exhausted and felt my heart beating heavy/rapid. Since then I’ve felt progressively worse.

Main problems now:

• Marked exhaustion after light–moderate activity (9 km commute by bike/ebike, carrying my bike up 3 flights, 7–15 km hikes).
• I often need to sit/rest 20–60+ minutes to recover. Sometimes I collapse on the sofa and sit for up to an hour.
• New/worsening chest pain and heavy breathing on exertion.
• Fluctuating course — some days I’m okay, other days I can’t do a short evening hike I’d normally manage.

Relevant events/tests:

• ~2 weeks after onset my GP ordered an ECG (normal) and bloods showing evidence consistent with recent mononucleosis — probable recent EBV infection.
• Subsequent ECGs (including today) have been normal.
• I had a bicycle accident (concussion, fractured thumb/wrist and ribs) but that didn’t noticeably change my baseline exhaustion.
• I went on a holiday with heavy sightseeing; that left me exhausted and I spent days in bed and then stayed off work for 2 weeks resting. I felt a bit better, returned to work (now taking the bus/walking since I can’t ride because of my thumb), but fatigue returned and worsened, with chest pain worsening beginning yesterday.
• GP has primarily advised rest; I feel they may be attributing it to psychological causes but I’m worried about an organic issue.

Other medical details:

• Diagnosed chronic migraine. Prophylaxis: trimipramine (off‑label). Acute: sumatriptan.
• New skin/eye findings: persistent bluish‑reddish bags under my eyes and a friend noticed a slight yellow tinge to the skin around my eyes since the holiday.

Treatments/management tried:

• Rest, reduced activity, time off work — no sustained improvement.

Current status / red flags:

• Progressive exercise intolerance; chest pain worsened beginning yesterday.
• No syncope reported. (No fever mentioned here.)

What I’m asking: Has anyone any idea what could be happening, I'm haven't really looked online or asked AI for what causes could be since the result somehow always is the worst possible thing fitting the symptoms instead of smaller things...