[19F] Experiencing sharp chest pain and persistent vomiting

Patient Description

A 19-year-old female presents with sharp, burning chest pain for the past three days, exacerbated by deep breaths and coughing spells, rated as 8/10 in severity. The pain persists at rest and is not relieved by any measures. Physical activity triggers coughing and vomiting. The patient reports vomiting after every meal throughout the day, accompanied by shortness of breath and wheezing. There is no blood in the vomit or coffee-ground appearance, and no fever, chills, or swelling in the legs or ankles. The patient had a COVID-19 infection approximately two months ago and was diagnosed with gastric issues in October. She smokes weed occasionally, which causes lightheadedness and nausea. Additionally, she has polycystic ovary syndrome (PCOS) and has not had a menstrual period in two months. The patient is not currently taking any medications and has no known allergies.

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Arora's Assessment

What might be happening

Based on the symptoms you've described, there are a few potential explanations for what you might be experiencing:

  1. Gastroesophageal Reflux Disease (GERD): Given your history of gastric issues, the sharp, burning chest pain that worsens with deep breaths and coughing could be related to acid reflux. GERD can cause chest pain, vomiting, and throat irritation, especially if the stomach acid is irritating your esophagus.

  2. Post-COVID-19 Effects: Since you had COVID-19 two months ago, some of your symptoms, like shortness of breath and wheezing, could be lingering effects of the infection. COVID-19 can sometimes lead to prolonged respiratory symptoms.

  3. Costochondritis: This is an inflammation of the cartilage that connects a rib to the breastbone, which can cause sharp chest pain that worsens with deep breathing or coughing.

  4. PCOS and Hormonal Imbalance: The absence of your period for two months could be related to your PCOS, which can cause hormonal imbalances and affect your overall health.

It's important to consult with a healthcare professional to get a proper diagnosis and treatment plan. They may recommend tests such as an ECG, chest X-ray, or endoscopy to better understand your condition.

What you can do

Chest Pain and Vomiting:

  • Avoid foods and drinks that trigger acid reflux, such as spicy foods, caffeine, and alcohol.
  • Eat smaller, more frequent meals instead of large meals.
  • Stay upright for at least 2-3 hours after eating to prevent acid reflux.
  • Consider over-the-counter antacids to help manage symptoms, but consult a doctor for long-term solutions.

Shortness of Breath and Wheezing:

  • Use a humidifier to keep the air moist, which can help ease breathing.
  • Practice deep breathing exercises to improve lung function.
  • Avoid smoking or exposure to smoke, as it can worsen respiratory symptoms.

General Health:

  • Keep track of your symptoms using the MDandMe app to monitor any changes and share this information with your healthcare provider.
  • Stay hydrated and maintain a balanced diet to support your overall health.
  • Schedule a follow-up appointment with your healthcare provider to discuss your symptoms and any necessary tests or treatments.

What you should look out for

Seek medical attention if you experience any of the following:

  • Severe or worsening chest pain
  • Difficulty breathing or shortness of breath that doesn't improve
  • Vomiting blood or material that looks like coffee grounds
  • Fainting or feeling lightheaded
  • Any new or concerning symptoms

Remember, it's important to consult with a healthcare professional for a formal diagnosis and appropriate treatment. They can provide personalized advice based on your specific situation.

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1 mo ago

People Also Ask


What are the common symptoms of Gastroesophageal Reflux Disease (GERD)?

Common symptoms of GERD include heartburn, chest pain, regurgitation of food or sour liquid, difficulty swallowing, and a sensation of a lump in the throat. It can also cause chronic cough, laryngitis, and disrupted sleep.


Can COVID-19 cause long-term respiratory symptoms?

Yes, COVID-19 can cause long-term respiratory symptoms such as shortness of breath, cough, and wheezing. These symptoms can persist for weeks or months after the initial infection, a condition sometimes referred to as 'long COVID.'


What is costochondritis and how is it treated?

Costochondritis is an inflammation of the cartilage that connects a rib to the breastbone, causing sharp chest pain that worsens with deep breathing or coughing. Treatment typically includes rest, pain relievers, and anti-inflammatory medications. In some cases, physical therapy may be recommended.


How does PCOS affect menstrual cycles?

PCOS can cause hormonal imbalances that affect the menstrual cycle, leading to irregular periods or even the absence of periods (amenorrhea). It can also cause other symptoms such as weight gain, acne, and excessive hair growth.


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