[18M] Experiencing untriggered chest pain

Patient Description

An 18-year-old male has been experiencing a pressure-like and dull chest pain for about a week, rated at approximately 3.5 out of 10 in severity. The pain occurs randomly, without any specific triggers, and sometimes is felt near the collarbone or towards the center of the chest. The patient reports an increase in heart rate during these episodes, likely due to nervousness. There are no other accompanying symptoms such as shortness of breath, sweating, weight loss, fever, or fainting. The patient has a history of cholinergic urticaria and takes Allertec as needed when his body temperature rises. No known allergies or other medications are reported.

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Arora's Assessment

What might be happening

Based on the information you've provided, possible causes of your symptoms include:

  • Costochondritis: This is an inflammation of the cartilage that connects a rib to the breastbone (sternum). It causes chest pain that can be triggered by coughing, deep breathing or physical activity. The pain is usually localized and can be reproduced by pressing on the affected area.

    • Treatment typically involves pain relievers such as nonsteroidal anti-inflammatory drugs (NSAIDs), rest, and avoiding activities that make your symptoms worse.
  • Anxiety or Panic Disorder: Anxiety can cause physical symptoms like chest pain, rapid heart rate, and shortness of breath. These symptoms can be very similar to those of heart disease, making it difficult to distinguish between the two without a doctor's help.

    • Treatment typically involves psychotherapy (talk therapy), medications, or both.
  • Gastroesophageal Reflux Disease (GERD): This is a chronic condition where stomach acid frequently flows back into the tube connecting your mouth and stomach (esophagus). This backwash (acid reflux) can irritate the lining of your esophagus and cause chest pain.

    • Treatment typically involves lifestyle changes and over-the-counter medications. If these don't help, your doctor might recommend prescription medications or surgery.

Please note that chest pain can also be a symptom of serious heart conditions, such as angina or a heart attack. It's important to seek immediate medical help if chest pain is severe, accompanied by other symptoms like shortness of breath, or if it's a new symptom.

What you can do

You should make an appointment with a healthcare provider to discuss your symptoms. They may want to perform tests to rule out more serious conditions. In the meantime, here are some things you can do:

  1. If the pain is mild and seems to be related to muscle strain or inflammation, you can try over-the-counter pain relievers like ibuprofen. Always follow the package instructions.
  2. Practice good posture and try to avoid activities that make your symptoms worse.
  3. If you notice that certain foods or eating habits seem to trigger symptoms, try to avoid them. This could be helpful if your chest pain is related to GERD.
  4. Practice stress management techniques, such as deep breathing, meditation, and yoga. This can be particularly helpful if your chest pain is related to anxiety.

What you should look out for

Please seek immediate medical attention if you experience any of the following:

  • Severe chest pain
  • Chest pain accompanied by shortness of breath, dizziness, fainting, or nausea
  • Chest pain that spreads to your jaw, left arm, or back
  • New or different chest pain, especially if you have a history of heart disease

Remember, this advice is intended to be general in nature, and specific causes may not apply to your situation. Always consult with a healthcare provider for appropriate examination, testing, and care recommendations.

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7 mo ago


People Also Ask


What is costochondritis and how is it treated?

Costochondritis is an inflammation of the cartilage that connects a rib to the breastbone, causing localized chest pain. Treatment typically involves pain relievers like NSAIDs, rest, and avoiding activities that worsen the symptoms.


Can anxiety cause chest pain and how is it managed?

Yes, anxiety can cause chest pain along with a rapid heart rate and shortness of breath. Management often includes psychotherapy, medications, or both, along with stress management techniques like deep breathing and meditation.


What are the symptoms of GERD and how can it be treated?

GERD symptoms include chest pain, heartburn, and acid reflux. Treatment involves lifestyle changes, over-the-counter medications, and possibly prescription medications or surgery if symptoms persist.


When should I seek immediate medical attention for chest pain?

Seek immediate medical attention if you experience severe chest pain, chest pain with shortness of breath, dizziness, fainting, nausea, or if the pain spreads to your jaw, left arm, or back, especially if you have a history of heart disease.

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