[18F] With severe headache, chest pain, and nausea

Patient Description

An 18-year-old female has been experiencing severe headaches for the past three months, occurring 3-4 times a week, with a severity of 8-10 out of 10. The headache is located in the center and left side of the head and feels like a thumping sensation. It is exacerbated by getting up too fast and exposure to light but is alleviated by Tylenol. The patient also reports chest pain and difficulty breathing deeply, along with nausea last night. There are no changes in vision, sensitivity to light or sound, fever, neck stiffness, rash, sudden severe headaches, or recent head injuries. The patient has no pre-existing conditions or chronic illnesses and is not currently taking any medications.

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Arora's Assessment

What might be happening

Based on the symptoms you have described, here are some possible conditions that might be causing your discomfort:

  • Migraines: Migraines are a type of headache that can cause severe throbbing pain, usually on one side of the head. They can last for hours to days and can be so severe that they interfere with your daily activities. Migraines are often accompanied by nausea, vomiting, and sensitivity to light and sound.

    • Treatment typically includes over-the-counter pain relievers like Tylenol or ibuprofen, prescription medications, and lifestyle changes to avoid triggers.
  • Tension Headaches: These are common headaches characterized by a dull, aching sensation all over the head. They can be triggered by stress, poor posture, or muscle tension.

    • Treatment often includes over-the-counter pain relievers, stress management techniques, and physical therapy.
  • Gastroesophageal Reflux Disease (GERD): GERD can cause chest pain and stomach pain, and sometimes nausea. This condition occurs when stomach acid frequently flows back into the tube connecting your mouth and stomach.

    • Treatment includes lifestyle changes, medications to reduce acid production, and in severe cases, surgery.
  • Anxiety or Panic Attacks: Anxiety can cause physical symptoms like chest pain, difficulty breathing, and nausea. These symptoms can sometimes be mistaken for other conditions.

    • Treatment includes therapy, medications, and stress management techniques.

What you can do

While you should see a healthcare professional for a formal diagnosis and treatment plan, here are some steps you can take in the meantime:

  1. Keep a Symptom Diary: Note when your symptoms occur, their severity, and any potential triggers. This information can be very helpful for your doctor.
  2. Hydrate and Eat Well: Ensure you are drinking plenty of water and eating a balanced diet. Avoid foods that trigger your symptoms.
  3. Over-the-Counter Medications: Continue using Tylenol for your headaches, but be cautious about overuse. You might also consider antacids if you suspect GERD.
  4. Stress Management: Practice relaxation techniques like deep breathing, meditation, or yoga to help manage stress, which can exacerbate your symptoms.

What you should look out for

Seek immediate medical attention if you experience any of the following:

  • Severe or Sudden Chest Pain: This could be a sign of a heart attack or other serious condition.
  • Shortness of Breath: If you find it increasingly difficult to breathe, seek help immediately.
  • Severe Headache with Other Symptoms: If your headache is accompanied by vision changes, weakness, confusion, or a stiff neck, you should see a doctor right away.
  • Persistent Vomiting: If you cannot keep fluids down, you may become dehydrated and need medical attention.

Remember, while this information can be helpful, it is not a substitute for professional medical advice. Please consult a healthcare provider for a thorough evaluation and appropriate treatment.

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7 mo ago

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People Also Ask


What are the common symptoms of migraines and how can they be managed?

Common symptoms of migraines include severe throbbing pain on one side of the head, nausea, vomiting, and sensitivity to light and sound. Management includes over-the-counter pain relievers, prescription medications, and lifestyle changes to avoid known triggers.


How can I differentiate between a migraine and a tension headache?

Migraines typically present with severe, throbbing pain on one side of the head and may include nausea and sensitivity to light and sound. Tension headaches usually cause a dull, aching sensation all over the head and are often related to stress or muscle tension.


What lifestyle changes can help manage GERD symptoms?

Lifestyle changes to manage GERD include avoiding foods and drinks that trigger reflux, eating smaller meals, not lying down immediately after eating, maintaining a healthy weight, and quitting smoking.


How can anxiety or panic attacks cause physical symptoms like chest pain and difficulty breathing?

Anxiety or panic attacks can cause physical symptoms due to the body's 'fight or flight' response, which can lead to increased heart rate, chest pain, and difficulty breathing. These symptoms can be managed with therapy, medications, and stress management techniques.


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