A 29 year-old female comes to the emergency room for continued chest pains for the last 8 months. The pain comes almost every day after she exercises in the gym, where she spends one to two hours every evening. For a few months, she self-medicated with omeprazole for possible GERD. Then she underwent a stress echocardiogram which yielded normal results. Her family doctor told her that her chest pains are most likely musculoskeletal in origin and she should take ibuprofen as needed. One of her friends died of pulmonary embolism and the patient would like to prevent a blood clot in her lungs by taking every precaution she can. For the last 8 months, she studied everything about pulmonary embolism. She volunteers in a health club where she frequently gives lectures on the prevention of pulmonary embolism. She makes TikTok videos, three to four times a week, on pulmonary embolism and participates in discussions with people who make comments under the videos. She has had over 6 pulmonary angiograms to rule out pulmonary embolism in the last 8 months. During one of those procedures, she got an anaphylactic reaction to the contrast dye, and ‘almost died’. All of them showed normal results but she is still worried. She drinks alcohol every day to soothe her anxiety. She does not want to die like her friend with a blood clot in her lungs. She requests you to order one more CT angiogram to rule out pulmonary embolism. She insists that would make her sleep better tonight. Which of the following is the most likely diagnosis in this patient?
