[19M] With dull right-sided chest pain

Patient Description

A 19-year-old male has been experiencing dull pain on the right side of his chest for about three weeks. The pain is rated as a 4 out of 10 in severity and occurs sporadically, lasting only a few moments. It worsens when lying on either side or flexing the shoulders inward, with no relief from any measures. There is no tenderness, shortness of breath, palpitations, or irregular heartbeats. The patient engages in physical labor and has not changed his activity or lifting routine recently. He used to smoke cannabis but quit six months ago and has been vaping nicotine less frequently, with no vaping in the past week. The patient traveled by plane recently from Vegas to Chicago without experiencing leg swelling or discomfort. His medical history includes hydronephrosis as an infant. He is allergic to penicillin, amoxicillin, and Bactrim and is not currently taking any medications.

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Arora's Assessment

What might be happening

Based on your symptoms, here are some possibilities:

  • Muscle Strain: Given your physical labor and lifting activities, it's possible that the pain is due to a muscle strain in your chest or shoulder area. This can occur from overuse or improper lifting techniques.

    • Treatment typically involves rest, avoiding activities that worsen the pain, and using over-the-counter pain relievers.
  • Costochondritis: This is an inflammation of the cartilage that connects a rib to the breastbone, often causing chest pain that worsens with certain movements.

    • Treatment may include anti-inflammatory medications and rest.
  • Pleurisy: Although less likely without respiratory symptoms, pleurisy involves inflammation of the tissues around the lungs, which can cause chest pain.

    • Treatment usually involves addressing the underlying cause and may include pain relief.

What you can do

  • Rest and Modify Activities: Try to rest and avoid activities that trigger the pain. Consider modifying your lifting techniques to reduce strain.
  • Apply Heat or Cold: Using a heating pad or ice pack on the affected area may help alleviate discomfort.
  • Over-the-Counter Pain Relief: Non-prescription pain relievers like ibuprofen or acetaminophen can help manage pain.
  • Symptom Tracking: Use MDandMe to journal your symptoms, track any changes, and share this information with your healthcare provider.

What you should look out for

Seek medical attention if you experience:

  • Increased severity or frequency of the pain
  • Shortness of breath, dizziness, or fainting
  • Any new or concerning symptoms

Remember, it's important to consult a healthcare professional for a formal diagnosis and appropriate treatment.

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3 mo ago

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People Also Ask


What are common causes of chest pain in young adults?

Common causes of chest pain in young adults include muscle strain, costochondritis, pleurisy, and sometimes anxiety or stress. It's important to consider the nature of the pain and any accompanying symptoms.


How can muscle strain in the chest be treated effectively?

Muscle strain in the chest can be treated with rest, avoiding activities that exacerbate the pain, applying heat or cold to the affected area, and using over-the-counter pain relievers like ibuprofen or acetaminophen.


What is costochondritis and how is it diagnosed?

Costochondritis is an inflammation of the cartilage connecting the ribs to the breastbone, causing chest pain. It is diagnosed based on a physical examination and the exclusion of other causes of chest pain. A healthcare provider may press on the chest to check for tenderness.


When should someone with chest pain seek medical attention?

Medical attention should be sought if chest pain increases in severity or frequency, is accompanied by shortness of breath, dizziness, fainting, or any new or concerning symptoms. These could indicate a more serious condition requiring prompt evaluation.


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