[20F] Experiencing chest pain, difficulty breathing, and vomiting

Patient Description

A 20-year-old female is reporting severe chest pain described as a tight squeezing sensation around the sternum and upper left back, moderate to severe difficulty breathing, and persistent vomiting for the last two days. The patient also describes a constant, throbbing headache with an intensity of 4 out of 10, located behind the eyes and occurring daily. The patient has a medical history significant for pulmonary embolisms and deep vein thrombosis but is not currently on any preventative treatment. Additionally, the patient reports feeling clammy and has cold extremities, with no recent travel, immobilization, or use of estrogen-containing contraceptives. No new leg swelling or discoloration has been noted. The patient's symptoms are concerning and could suggest a serious condition such as a recurrent pulmonary embolism or another cardiac or respiratory issue. Immediate medical evaluation is strongly recommended.

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Arora's Assessment

What might be happening

Based on the information you've provided, you're experiencing several symptoms that could indicate a serious condition. Given your history of pulmonary embolisms and deep vein thrombosis, your current symptoms of chest pain, difficulty breathing, and vomiting could potentially indicate another pulmonary embolism. This is a condition where one or more arteries in your lungs become blocked by a blood clot. This is a serious condition that can damage your lungs and other organs in your body due to reduced oxygen flow.

What you can do

Given the severity of your symptoms and your medical history, it's important to seek immediate medical attention. Please go to the nearest emergency room or call an ambulance. Do not attempt to drive yourself.

What you should look out for

If your symptoms worsen or if you experience any of the following, it's crucial to seek immediate medical attention:

  • Increased difficulty breathing
  • Severe chest pain
  • Coughing up blood
  • A sudden onset of sharp, severe pain in your leg
  • Swelling, redness, or warmth in your leg

Remember, this advice is intended to be general in nature, and specific causes may not apply to your situation. Always consult with a healthcare provider for appropriate examination, testing, and care recommendations.

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10 mo ago

People Also Ask


What are the common symptoms of a pulmonary embolism?

Common symptoms of a pulmonary embolism include sudden shortness of breath, chest pain that may become worse when breathing deeply or coughing, rapid heart rate, and coughing up blood. Some people may also experience dizziness, sweating, or leg pain and swelling.


How is a pulmonary embolism diagnosed?

A pulmonary embolism is typically diagnosed using imaging tests such as a CT pulmonary angiography, which provides detailed images of the blood vessels in the lungs. Other tests may include a D-dimer blood test, ultrasound of the legs, or a ventilation-perfusion (V/Q) scan.


What are the risk factors for developing deep vein thrombosis?

Risk factors for developing deep vein thrombosis include prolonged periods of immobility (such as long flights or bed rest), surgery, certain medical conditions that affect blood clotting, pregnancy, and the use of estrogen-containing medications. A personal or family history of blood clots also increases risk.


What should I do if I suspect I have a pulmonary embolism?

If you suspect you have a pulmonary embolism, it is crucial to seek immediate medical attention. Go to the nearest emergency room or call an ambulance. Do not attempt to drive yourself, as this condition can rapidly become life-threatening.


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