[20F] Experiencing chest and upper back pain, easy bruising, and lightheadedness

Patient Description

A 20-year-old female reports experiencing moderate to severe chest and upper back pain, easy bruising, persistent moderate nasal congestion, occasional chills, and lightheadedness that is particularly worse in the mornings and when standing up, rating it a 6 in severity. The lightheadedness typically lasts a few minutes and is alleviated by sitting back down. The patient has been dealing with nasal congestion for months and the lightheadedness for a few weeks. There is no recent history of injuries or accidents. The patient is not currently pregnant.

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Arora's Assessment

What might be happening

Based on the symptoms you've described, here are a few possibilities:

  • Anemia: This condition, which is characterized by a lack of healthy red blood cells, could explain your fatigue, lightheadedness, and easy bruising. It's typically diagnosed with a blood test.
  • Orthostatic Hypotension: This condition, which is a form of low blood pressure, happens when you stand up from sitting or lying down and you feel dizzy. It could explain your lightheadedness.
  • Allergies or Chronic Sinusitis: These could be causing your stuffy nose. Allergies are typically diagnosed by an allergist, who may perform skin or blood tests. Chronic sinusitis is typically diagnosed by an ENT (ear, nose, and throat) specialist, who may perform a physical exam and imaging tests.
  • Musculoskeletal Pain: This could be causing your chest and upper back pain. It's typically diagnosed by a physical exam and possibly imaging tests.

What you can do

While you should definitely seek medical attention for a formal diagnosis, here are a few things you can do in the meantime:

  1. For your stuffy nose, try over-the-counter decongestants or nasal sprays. You can also try a humidifier or taking a hot shower to help clear your nasal passages.
  2. For your chest and upper back pain, try over-the-counter pain relievers. You can also try applying heat or cold to the area to see if it helps.
  3. For your lightheadedness, make sure to get up slowly when you've been sitting or lying down. You can also try to stay hydrated and limit your intake of caffeine and alcohol, which can both cause dehydration.
  4. For your fatigue, make sure you're getting enough sleep and eating a healthy diet. You can also try to get regular exercise, which can help boost your energy levels.

What you should look out for

If any of the following occur, you should seek medical attention immediately:

  • Chest pain that is severe, lasts more than a few minutes, or is accompanied by shortness of breath, sweating, nausea, or pain radiating to your jaw, neck, or arm
  • Lightheadedness that is severe, lasts more than a few minutes, or is accompanied by fainting, chest pain, or shortness of breath
  • A stuffy nose that is accompanied by severe headache, facial pain, or fever
  • Back pain that is severe, lasts more than a few weeks, or is accompanied by numbness or weakness in your legs, loss of bladder or bowel control, or unexplained weight loss

Please remember that while I strive to provide accurate information, I'm not a doctor. You should definitely seek medical attention for your symptoms.

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10 mo ago

People Also Ask


What could be causing my lightheadedness when I stand up?

Your lightheadedness when standing up could be due to orthostatic hypotension, a condition where blood pressure drops significantly upon standing, causing dizziness. Staying hydrated and rising slowly from sitting or lying positions can help manage this symptom.


Why am I experiencing easy bruising?

Easy bruising can be a sign of anemia, which is a condition characterized by a lack of healthy red blood cells. It can also be due to other factors like certain medications or vitamin deficiencies. A blood test can help diagnose the cause.


What are some home remedies for persistent nasal congestion?

For persistent nasal congestion, you can try over-the-counter decongestants or nasal sprays, use a humidifier, or take hot showers to help clear your nasal passages. If symptoms persist, consulting a healthcare provider is recommended.


When should I be concerned about chest and upper back pain?

You should be concerned about chest and upper back pain if it is severe, lasts more than a few minutes, or is accompanied by symptoms like shortness of breath, sweating, nausea, or pain radiating to your jaw, neck, or arm. In such cases, seek medical attention immediately.


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