[20F] Experiencing abdominal pain, breast tenderness, and heart palpitations

Patient Description

A 20-year-old female presents with sharp, stabbing lower abdominal pain rated 7-8/10 in severity, exacerbated by walking and relieved somewhat by lying down. The pain is localized to the lower abdomen and right side. She also reports breast tenderness in both breasts, unusual for her, rated 7-8/10 in severity, and heart palpitations described as fluttering, which have increased in frequency over the past day. The patient has a history of a heart murmur diagnosed 5-6 years ago and is currently taking Singulair (montelukast) with an unclear dosage and frequency. Menstrual cycles have been occurring two weeks apart for the past 2-3 months, and there is pain during urination. The patient has been sexually active without contraception, with the most recent instance two days ago. No allergies or adverse reactions to medications have been reported.

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Arora's Assessment

What might be happening

Based on the information you have provided, possible explanations for your symptoms include:

  • Urinary Tract Infection (UTI): A UTI can cause lower abdominal pain and discomfort during urination. This is usually accompanied by a frequent urge to urinate and sometimes cloudy, strong-smelling urine.

    • Treatment typically involves antibiotics prescribed by a doctor.
  • Pregnancy: Given your recent unprotected sexual activity, changes in your menstrual cycle, and breast tenderness, it's possible that you could be pregnant. Early pregnancy can sometimes cause lower abdominal pain or discomfort.

    • Confirming pregnancy typically involves a home pregnancy test or a blood test at a doctor's office.
  • Premenstrual Syndrome (PMS): PMS can cause breast tenderness, abdominal pain, and changes in mood or behavior. However, this usually occurs in the week or two leading up to your period.

    • Treatment can involve lifestyle changes, such as regular exercise and a healthy diet, and sometimes medication.
  • Anxiety or Stress: Heart palpitations can sometimes be caused by stress or anxiety. However, given your history of a heart murmur, it's important to have any changes in your heart rhythm checked out by a doctor.

    • Treatment can involve stress management techniques, therapy, and sometimes medication.

Please note that these are just possibilities and not a definitive diagnosis. It's important to consult with a healthcare professional who can evaluate your symptoms and medical history in person.

What you can do

  1. Schedule an appointment with a healthcare provider as soon as possible to discuss your symptoms. They may want to conduct further tests to determine the cause of your symptoms.
  2. If you think there's a chance you could be pregnant, consider taking a home pregnancy test. These are typically available at pharmacies and grocery stores.
  3. Drink plenty of water and avoid caffeine, which can irritate the bladder and worsen UTI symptoms.
  4. Try to rest and avoid strenuous activity, which could worsen your abdominal pain.

What you should look out for

Seek immediate medical attention if:

  • Your abdominal pain becomes severe or unbearable
  • You notice blood in your urine
  • You develop a high fever (over 100.4°F)
  • You experience sudden, severe chest pain or difficulty breathing

Remember, I'm an AI and this advice is not a substitute for professional medical advice. Please consult with a healthcare provider.

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10 mo ago

People Also Ask


What are the common symptoms of a urinary tract infection (UTI)?

Common symptoms of a UTI include a strong, persistent urge to urinate, a burning sensation when urinating, passing frequent, small amounts of urine, cloudy or strong-smelling urine, and pelvic pain, especially in women.


How can I confirm if I am pregnant?

Pregnancy can be confirmed by taking a home pregnancy test, which detects the presence of the hormone hCG in urine. For more accurate results, a blood test can be done at a doctor's office.


What are some ways to manage premenstrual syndrome (PMS) symptoms?

Managing PMS symptoms can involve lifestyle changes such as regular exercise, a balanced diet, adequate sleep, and stress management. Over-the-counter pain relievers and certain medications may also help alleviate symptoms.


Can stress or anxiety cause heart palpitations?

Yes, stress or anxiety can cause heart palpitations, which are feelings of having a fast-beating, fluttering, or pounding heart. However, it's important to consult a doctor, especially if you have a history of heart conditions.


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