[21F] Experiencing chest pain and multiple symptoms

Patient Description

A 21-year-old female reports experiencing constant chest pain rated at 8 out of 10 in severity, which has been present for several weeks. The pain worsens with breathing and any physical activity, and is exacerbated by lying down. The patient also reports symptoms of trouble breathing, exhaustion, anxiety, confusion, memory problems, stomach pain, and numbness. She denies any recent substance use, including caffeine, alcohol, or drugs, and has not found any relief measures for her symptoms. There is no history of recent injuries or trauma to the chest area.

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Arora's Assessment

What might be happening

Based on the symptoms you've described—trouble breathing, exhaustion, anxiety, confusion, memory problems, stomach pain, numbness, and particularly chest pain that worsens with breathing or activity and is severe—there are several potential concerns:

  1. Heart-Related Issues: Your symptoms could indicate a heart-related condition, such as angina or even a heart attack, especially given the severity and nature of your chest pain. Heart conditions can cause chest pain, shortness of breath, and fatigue. Immediate medical evaluation is crucial.

  2. Pulmonary Embolism: This is a serious condition where a blood clot travels to the lungs, causing chest pain, difficulty breathing, and sometimes confusion or anxiety. It requires urgent medical attention.

  3. Pneumonia or Pleuritis: These conditions can cause chest pain that worsens with breathing, along with shortness of breath and fatigue. They can also lead to confusion, especially in severe cases.

  4. Anxiety or Panic Disorder: While anxiety can cause chest pain and shortness of breath, the severity of your symptoms warrants a medical evaluation to rule out more serious conditions first.

What you can do

Given the severity and combination of your symptoms, it is important to seek immediate medical attention. Here’s what you can do:

  • Call 911 or Emergency Services: Given the potential for a serious condition like a heart attack or pulmonary embolism, it is crucial to get emergency medical help right away. Do not attempt to drive yourself to the hospital.

  • Stay Calm and Rest: While waiting for help, try to stay as calm as possible and rest in a comfortable position. Avoid any physical activity that could worsen your symptoms.

  • Inform Someone Nearby: If possible, let someone nearby know about your condition so they can assist you until help arrives.

Remember, it is always better to err on the side of caution with symptoms like these. Please seek immediate medical care.

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People Also Ask


What are the common symptoms of a heart attack in young adults?

Common symptoms of a heart attack in young adults include chest pain or discomfort, which may feel like pressure, squeezing, or fullness. Other symptoms can include shortness of breath, nausea, lightheadedness, and pain or discomfort in one or both arms, the back, neck, jaw, or stomach.


How can anxiety or panic disorders cause chest pain?

Anxiety or panic disorders can cause chest pain due to the body's 'fight or flight' response, which can lead to muscle tension, increased heart rate, and hyperventilation. These physiological changes can mimic or exacerbate chest pain.


What is a pulmonary embolism and what are its symptoms?

A pulmonary embolism is a blockage in one of the pulmonary arteries in the lungs, usually caused by blood clots that travel to the lungs from the legs or other parts of the body. Symptoms include sudden shortness of breath, chest pain that may become worse when breathing deeply, coughing, and sometimes confusion or anxiety.


How can pneumonia or pleuritis lead to chest pain and difficulty breathing?

Pneumonia is an infection that inflames the air sacs in one or both lungs, which can fill with fluid or pus, causing cough, fever, chills, and difficulty breathing. Pleuritis, or pleurisy, is inflammation of the tissues that line the lungs and chest cavity, leading to sharp chest pain that worsens with breathing.


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