[20M] Experiencing a range of symptoms including chest pain and swollen lymph nodes

Patient Description

A 20-year-old male has been experiencing a variety of symptoms for up to two years, including upper left side chest pain, weakness, headaches, shaky legs and hands, anxiety, and weight gain. The chest pain, described as dull and rated a 3 out of 10 in severity, worsens when sitting still or laying down and does not change with breathing or coughing. The patient has been feeling constant fatigue for the past 8 months, rating the severity of weakness as 8 out of 10. Headaches, described as throbbing and dull, have been occurring for 2-3 months, primarily behind the eyes or at the back of the head, with an intensity rated at 6 out of 10. Anxiety has been an issue for 2 years. Swollen lymph nodes have been present for a year on the left side of the neck and under the jaw, as well as in the groin area. Shaky legs and hands have been noted for 2-3 months, with no relief identified. The patient has also noticed petechiae spots, neck stiffness, lower back pain, and intermittent spleen pain. There have been no night sweats, but a slight fever was mentioned. No current medications are being taken, and there is no history of pre-existing conditions or chronic illnesses. The patient's symptoms come and go, impacting daily activities significantly.

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Arora's Assessment

What might be happening

Based on the information you've provided, possible diagnoses include:

  • Systemic Lupus Erythematosus (SLE): This is an autoimmune disease that can affect many different body systems, including your skin, joints, and internal organs. It can cause a wide range of symptoms, including fatigue, joint pain, rash, and swollen lymph nodes. However, it's important to note that lupus is a complex disease that can present in many different ways and it can only be diagnosed by a healthcare provider.

    • Treatment for lupus typically involves medications to manage symptoms and prevent flare-ups, such as nonsteroidal anti-inflammatory drugs (NSAIDs), corticosteroids, antimalarial drugs, and immunosuppressants.
  • Fibromyalgia: This is a disorder characterized by widespread musculoskeletal pain accompanied by fatigue, sleep, memory and mood issues. It is often considered when there are multiple areas of pain and tenderness, fatigue, and other symptoms like you described.

    • Treatment for fibromyalgia often involves a combination of medications, exercise, stress management techniques, and healthy lifestyle habits.
  • Chronic Fatigue Syndrome (CFS): This is a complex disorder characterized by extreme fatigue that can't be explained by any underlying medical condition. The fatigue may worsen with physical or mental activity, but doesn't improve with rest. Other symptoms can include weakness, swollen lymph nodes, and joint pain.

    • Treatment for CFS typically involves a combination of lifestyle changes, psychological therapy, and medication to manage symptoms.
  • Anxiety Disorder: Chronic anxiety can cause a wide range of physical symptoms, including chest pain, headaches, and shaking. It can also cause fatigue and interfere with your ability to work or perform daily activities.

    • Treatment for anxiety disorders typically involves a combination of psychotherapy (talk therapy), cognitive behavioral therapy, and medication.

Please note that these are only possibilities and not a definitive diagnosis. It's important to consult with a healthcare provider for an accurate diagnosis and treatment.

What you can do

  1. Schedule an appointment with your healthcare provider to discuss your symptoms. They may refer you to a specialist, such as a rheumatologist, for further evaluation.
  2. Keep a symptom diary. This can help you track when your symptoms occur, how long they last, and any potential triggers. This can be helpful information to share with your healthcare provider.
  3. Try to maintain a healthy lifestyle. This includes eating a balanced diet, getting regular physical activity, ensuring you get enough sleep, and managing stress.

What you should look out for

Seek immediate medical attention if you experience:

  • Severe chest pain or difficulty breathing
  • A sudden, severe headache
  • A rash that is spreading rapidly
  • Any other symptoms that are severe or concerning to you

Please remember that while I strive to provide accurate information, I'm not a doctor and this advice should not replace a consultation with a healthcare provider.

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7 mo ago


People Also Ask


What are the common symptoms of Systemic Lupus Erythematosus (SLE)?

Common symptoms of Systemic Lupus Erythematosus (SLE) include fatigue, joint pain, skin rashes, swollen lymph nodes, and sensitivity to sunlight. It can also affect internal organs and cause a wide range of other symptoms.


How is fibromyalgia typically treated?

Fibromyalgia is typically treated with a combination of medications such as pain relievers, antidepressants, and anti-seizure drugs. Additionally, exercise, stress management techniques, and healthy lifestyle habits are important components of treatment.


What lifestyle changes can help manage Chronic Fatigue Syndrome (CFS)?

Lifestyle changes that can help manage Chronic Fatigue Syndrome (CFS) include maintaining a balanced diet, engaging in regular but moderate physical activity, ensuring adequate sleep, and managing stress through relaxation techniques or therapy.


What are some effective treatments for anxiety disorders?

Effective treatments for anxiety disorders often include psychotherapy, such as cognitive behavioral therapy (CBT), and medications like antidepressants or anti-anxiety drugs. Lifestyle changes and stress management techniques can also be beneficial.

1 Comments


Leo#3962

7 mo ago

I'm sorry that you're dealing with such a complicated set of symptoms. Given the lymph node enlargement, petechiae spots, and your fatigue, I'd recommend having a physician run some blood tests as soon as possible. Some things to pay attention to in those tests include autoimmune antibodies and abnormal blood cell counts

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