<s>[INST] Looking for some insight regarding my 16-year old son. He is 6 0 and weighs 200 pounds. He has a bad habit of lying in front of the television playing Xbox live for hours and hours on end. A few days ago he started complaining of a rapid heart rate, and having a hard time breathing. I took him to the ER, and the doctors said there was nothing physically wrong with him, and that it sounds like he was having a panic attack. It s been a few days, but there has been no improvement. He feels clamy, says he feels hot and cold at the same time, head hurts, nose hurts even though he says it isn t stuffed up, and has been running a slight fever around 100. Not sure if it s some sort of viral infection or what s going on, only that he has been afraid to go to sleep at night because he is scared he won t wake up. Any thoughts? Other than being lazy during the summer, he is a normal healthy kid. But he says he feels out of it, hard time thinking, and has quite a bit of shortness of breath. [/INST] Hi... the initial heart rate and palpitation could as well be a panic attack. But the other symptoms which he is now experiencing do not fit into any known clinical picture or clinical syndrome to diagnose any specific condition. You may be right in considering a subtle viral infection. But I strongly feel that it could also be a conversion reaction. I suggest you consult your pediatrician regarding this.Regards - Dr. Sumanth </s>