[21F] Experiencing persistent migraines and sore throat with chest pain

Patient Description

A 21-year-old female presents with a persistent migraine lasting a week and a half, which is longer than her usual migraine episodes. The pain fluctuates between a moderate to mild intensity and is exacerbated by reading, physical activity, lights, and noise. She also reports an achy chest pain that worsens with breathing, rated at a 4.5 out of 10 in severity, and a sore throat that is particularly painful when swallowing, lying down, or talking, and is worse in the mornings and nights. Additionally, she has been experiencing mild brown, sticky phlegm and light sensitivity but no fever, chills, or difficulty breathing. She has a history of asthma, POTS, and vasovagal syncope, and is allergic to penicillin. Currently, she takes Benadryl for allergies and Prilosec as needed. The patient works as a CNA at a nursing home and has been exposed to individuals with respiratory illnesses.

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Arora's Assessment

What might be happening

Based on the information you've provided, here are some possible explanations for your symptoms:

  • Upper Respiratory Tract Infection: This is a common cause of sore throat, chest discomfort, and phlegm production. Given your exposure to sick individuals at the nursing home where you work, this could be a likely cause. The brown color of your phlegm could be due to the presence of old blood or infection.

    • Treatment usually involves rest, hydration, and over-the-counter remedies to manage symptoms. If a bacterial infection is suspected, antibiotics may be prescribed by a doctor.
  • Migraine: You've mentioned a history of migraines, and your current headache seems consistent with this. However, the longer duration and increased sensitivity to triggers could suggest a more severe or prolonged migraine episode.

    • Treatment typically involves medications to relieve symptoms and prevent future attacks. If your current medication isn't working, your doctor may suggest trying a different one.
  • Asthma: Your chest discomfort and difficulty breathing could be related to your asthma, especially if you've been exposed to triggers recently. However, without a cough or wheezing, this seems less likely.

    • Treatment involves using prescribed inhalers and avoiding triggers.

Please note that these are just possibilities and not a definitive diagnosis. You should consult with a healthcare provider for an accurate diagnosis and treatment.

What you can do

  1. Rest and stay hydrated. This can help your body fight off an infection if that's the cause of your symptoms.
  2. Continue taking your migraine medication as prescribed. If it's not helping, don't hesitate to contact your healthcare provider.
  3. Avoid triggers that can worsen your migraine, such as bright lights and loud noises.
  4. Monitor your symptoms. If your sore throat, chest discomfort, or phlegm production worsens, seek medical attention.

What you should look out for

Seek immediate medical attention if you experience:

  • Difficulty breathing or shortness of breath
  • Severe chest pain
  • A severe headache or a headache that is different from your usual migraines
  • Fever or chills
  • Coughing up blood or large amounts of phlegm

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 accurate information.

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10 mo ago

People Also Ask


What could be causing my persistent migraine and how can I manage it?

Persistent migraines can be caused by various factors including stress, changes in routine, or exposure to triggers like bright lights and noise. Management typically involves medications to relieve symptoms and prevent future attacks. If your current treatment isn't effective, consult your doctor for alternative options.


Why am I experiencing chest pain that worsens with breathing?

Chest pain that worsens with breathing could be due to an upper respiratory tract infection or inflammation in the chest area. It's important to monitor the pain and seek medical attention if it worsens or is accompanied by other symptoms like difficulty breathing.


What does brown phlegm indicate and should I be concerned?

Brown phlegm can indicate the presence of old blood or an infection. While it can be a sign of a respiratory infection, it's important to monitor other symptoms and consult a healthcare provider if it persists or is accompanied by other concerning symptoms.


How can I differentiate between a migraine and a more serious headache condition?

Migraines are typically characterized by throbbing pain, sensitivity to light and sound, and sometimes nausea. A more serious headache condition might involve sudden, severe pain, neurological symptoms, or a headache that is different from your usual pattern. If you experience these, seek medical attention.


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