[19F] Experiencing severe chest pain with radiating discomfort

Patient Description

A 19-year-old female reports experiencing severe chest pain described as a tightness and sharpness, feeling like pressure is being applied to the chest. This pain has been present for approximately an hour, worsening with any activity, and has not been alleviated by any specific actions or positions. The pain is centrally located over the heart area and is accompanied by a rapid and rough heart rate, shortness of breath, and radiates to the arm, shoulder, neck, or jaw. The patient rates the pain as 7 out of 10 in severity. There is a family history of heart disease. The patient has been taking Zoloft (100mg), Wellbutrin (300mg), and Strattera (80mg) for several years without reported side effects and has used a small amount of marijuana recently. No known allergies or adverse reactions to medications have been reported. The patient is also taking unspecified over-the-counter medications, supplements, or herbal remedies.

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Arora's Assessment

What might be happening

Based on your symptoms, there are several possibilities:

  • Panic Attack: This is a type of anxiety disorder where you have sudden attacks of intense fear that trigger severe physical reactions when there is no real danger or apparent cause. The symptoms can mimic those of a heart attack and include chest pain, rapid heart rate, and shortness of breath.

    • Treatment typically involves cognitive behavioral therapy and medication for anxiety.
  • Heart Conditions: Given your symptoms of chest pain, rapid heart rate, and shortness of breath, it's important to consider conditions like angina or even a heart attack. These conditions are less common in young people but can still occur, especially with a family history of heart disease.

    • Treatment for these conditions typically involves medications, lifestyle changes, and possibly surgery.
  • Side Effects of Medication: Some of the medications you're taking, such as Wellbutrin and Strattera, can cause increased heart rate and chest pain as side effects.

    • Treatment would involve discussing these side effects with your doctor and possibly adjusting your medication.

What you can do

Given the severity of your symptoms, it's important to seek immediate medical attention. Chest pain and shortness of breath can be signs of serious conditions, including heart disease. If you're alone, call 911. If you're with someone, have them drive you to the nearest emergency department.

What you should look out for

If your symptoms worsen or you start to experience additional symptoms such as fainting, severe shortness of breath, or severe chest pain, seek immediate medical attention.

Remember, I'm an AI and this advice is based on the information you've provided. It's always important to consult with a healthcare provider for a formal diagnosis and treatment.

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8 mo ago


People Also Ask


What are the common symptoms of a panic attack, and how can they be distinguished from a heart attack?

Common symptoms of a panic attack include sudden intense fear, chest pain, rapid heart rate, shortness of breath, dizziness, and sweating. These can mimic a heart attack, but panic attacks often occur in the absence of physical exertion and may be accompanied by a sense of impending doom. A heart attack typically involves more persistent chest pain and may be associated with physical exertion or stress.


How can family history of heart disease affect a young person's risk of heart conditions?

A family history of heart disease can increase a young person's risk of developing heart conditions due to genetic factors. It is important for individuals with such a history to monitor their heart health closely, maintain a healthy lifestyle, and consult with healthcare providers for regular check-ups.


What are the potential side effects of medications like Wellbutrin and Strattera that could mimic heart-related symptoms?

Wellbutrin and Strattera can cause side effects such as increased heart rate, chest pain, and anxiety, which may mimic heart-related symptoms. It is important to discuss any concerning side effects with a healthcare provider, who may adjust the medication dosage or suggest alternatives.


What immediate actions should be taken if someone experiences severe chest pain and shortness of breath?

If someone experiences severe chest pain and shortness of breath, they should seek immediate medical attention. Call 911 or go to the nearest emergency department, as these symptoms could indicate a serious condition like a heart attack. It is crucial not to ignore these symptoms, especially if they are accompanied by fainting or severe discomfort.

1 Comments


Leo#17

8 mo ago

You know your body best so if you feel that these symptoms are serious, different, or not something you've had before, go to the ER. They will likely tell you given your age and as a young woman you are having a panic attack but at least they will probably do an ECG and maybe order some labs. They might also do a drug screen because if these symptoms began after substance use that changes the diagnosis

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