[21F] With chest pain, shortness of breath, and cold sweats

Patient Description

A 21-year-old female has been experiencing chest pains, upper back pain, shortness of breath, and cold sweats for the past five days. The shortness of breath is severe (rated 8/10) and occurs with all activities, with no relief from any measures. The chest pain is described as sharp and worsens with inhalation, affecting both the chest and upper back, making it difficult to take a full breath. Additionally, the patient reports heart palpitations that feel like fluttering, occurring randomly and triggered by attempts to take deep breaths. The patient has a history of anxiety, which has been more intense lately, and was diagnosed with high cholesterol three weeks ago. She occasionally vapes nicotine daily but has experienced similar symptoms before starting vaping. The patient is currently taking Zoloft 50 mg approximately three times a week. There is no history of fever, cough, or known allergies. The patient suspects she might have asthma but has never been tested or used an inhaler.

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Arora's Assessment

What might be happening

Based on the symptoms you've described, there are several serious conditions that could be causing your symptoms:

  1. Heart Attack (Myocardial Infarction): Your symptoms of chest pain, shortness of breath, and cold sweats are classic signs of a heart attack. This is a medical emergency that requires immediate attention. Heart attacks occur when the blood flow to a part of the heart is blocked, causing damage to the heart muscle.

  2. Pulmonary Embolism: This condition occurs when a blood clot travels to the lungs, causing sudden shortness of breath, chest pain, and sometimes back pain. It is also a medical emergency and requires immediate treatment.

  3. Pneumothorax (Collapsed Lung): Sudden sharp chest pain and difficulty breathing can be signs of a collapsed lung. This can happen spontaneously or due to an injury and requires urgent medical care.

  4. Severe Asthma Attack: Although you haven't been diagnosed with asthma, your symptoms could be indicative of a severe asthma attack, especially given your history of vaping. This can cause significant shortness of breath and chest pain.

  5. Anxiety or Panic Attack: While anxiety can cause symptoms like shortness of breath and chest pain, the severity and persistence of your symptoms suggest that a more serious condition should be ruled out first.

What you can do

Given the severity and nature of your symptoms, it is crucial that you seek immediate medical attention. Here are the steps you should take:

  1. Call 911 or Emergency Services: Given the possibility of a heart attack, pulmonary embolism, or other serious conditions, you should call 911 or your local emergency number immediately. Do not wait or try to drive yourself to the hospital.

  2. Stay Calm and Rest: While waiting for emergency services, try to stay as calm as possible and rest in a comfortable position. Avoid any physical exertion.

  3. Inform Someone Nearby: If you are not alone, inform someone nearby about your symptoms so they can assist you and provide information to emergency responders.

  4. Avoid Eating or Drinking: Until you are evaluated by medical professionals, avoid eating or drinking anything, as this could complicate potential treatments.

Remember, I am not a doctor, and this advice is based on the information you have provided. It is essential to get a formal diagnosis and treatment from a healthcare professional. Please seek care immediately.

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3 mo ago


People Also Ask


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

Common symptoms of a heart attack in young women include chest pain or discomfort, shortness of breath, cold sweats, nausea, lightheadedness, and pain in the neck, back, or jaw. These symptoms can sometimes be less pronounced than in men, making them harder to recognize.


Can anxiety cause symptoms similar to a heart attack?

Yes, anxiety can cause symptoms that mimic a heart attack, such as chest pain, shortness of breath, heart palpitations, and sweating. However, it's important to rule out a heart attack or other serious conditions first, especially if the symptoms are severe or persistent.


How does vaping affect respiratory health?

Vaping can negatively affect respiratory health by causing inflammation and irritation in the lungs, which may lead to symptoms like shortness of breath, chest pain, and coughing. Long-term use can increase the risk of developing chronic respiratory conditions.


What are the signs of a pulmonary embolism?

Signs of a pulmonary embolism include sudden shortness of breath, sharp chest pain that may worsen with deep breaths, rapid heart rate, dizziness, and sometimes coughing up blood. It is a serious condition that requires immediate medical attention.


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