[22F] Experiencing chest pains with associated nausea and shortness of breath

Patient Description

A 22-year-old female has been experiencing stabbing chest pains for approximately three weeks, rated at a severity of 6 out of 10. The pain is present in the middle of the chest and radiates to the right and left sides. It worsens when lying down and is somewhat alleviated by heat. Additionally, the patient experiences nausea and shortness of breath, particularly when anxious or lying down, which started about a week ago and is rated at a severity of 3 out of 10. The patient has a history of cancer treatment at a young age and suffers from chronic back pain due to herniated discs. There is a family history of cardiac or gastrointestinal conditions. The patient reports using a vape and is not currently on any medications. No known drug allergies or adverse reactions to medications have been reported.

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Arora's Assessment

What might be happening

Based on your symptoms, here are a few possible conditions:

  • Gastroesophageal Reflux Disease (GERD): This is a digestive disorder that occurs when acidic stomach juices, or food and fluids back up from the stomach into the esophagus. GERD affects people of all ages and often produces symptoms like heartburn, chest pain, and shortness of breath, especially after eating or when lying down.

    • Treatment usually involves lifestyle changes and over-the-counter medications. In severe cases, prescription medications or surgery may be required.

  • Anxiety or Panic Disorder: Anxiety can cause physical symptoms like chest pain, shortness of breath, and nausea. These symptoms can be more noticeable during periods of high stress or when you're feeling anxious.

    • Treatment often involves a combination of psychotherapy (talk therapy), cognitive behavioral therapy, and medication.

  • Costochondritis: This is an inflammation of the cartilage that connects a rib to the breastbone (sternum). It causes chest pain that can be reproduced by pushing on the chest wall, and can sometimes be confused with more serious conditions, like a heart attack.

    • Treatment usually involves pain relievers and rest.

Please note that chest pain can sometimes be a sign of serious heart conditions. Although your symptoms do not seem to align with these conditions, it's important to seek immediate medical attention if your symptoms worsen.

What you can do

  1. Try to avoid foods and drinks that trigger heartburn. Everyone has specific triggers, but common ones include fatty or fried foods, tomato sauce, alcohol, chocolate, mint, garlic, onion, and caffeine.
  2. Try to eat smaller meals.
  3. Don't lie down after a meal. Wait at least three hours.
  4. Elevate the head of your bed if you regularly experience heartburn at night or while trying to sleep.
  5. If you smoke, quit. Smoking decreases the lower esophageal sphincter's ability to function properly.

What you should look out for

Seek immediate medical care if you have chest pain that does not go away, crushing pain or pressure in the chest, or chest pain along with nausea, sweating, dizziness or shortness of breath. These could be potential signs of a heart attack.

Remember, I'm an AI and this advice is based on the information you've given me. It's always a good idea to consult with a healthcare professional who can evaluate your symptoms and medical history.

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9 mo ago

People Also Ask

What are the common symptoms of Gastroesophageal Reflux Disease (GERD)?

Common symptoms of GERD include heartburn, chest pain, regurgitation of food or sour liquid, difficulty swallowing, and a sensation of a lump in the throat. Symptoms often worsen after eating or when lying down.

How can anxiety or panic disorders cause physical symptoms like chest pain?

Anxiety or panic disorders can cause physical symptoms due to the body's 'fight or flight' response, which can lead to increased heart rate, muscle tension, and hyperventilation. These physiological changes can result in chest pain, shortness of breath, and nausea.

What is costochondritis and how is it different from a heart attack?

Costochondritis is an inflammation of the cartilage connecting the ribs to the breastbone, causing localized chest pain that can be reproduced by pressing on the chest. Unlike a heart attack, costochondritis does not cause symptoms like crushing chest pain, sweating, or dizziness.

What lifestyle changes can help manage GERD symptoms?

Lifestyle changes to manage GERD include avoiding trigger foods and drinks, eating smaller meals, not lying down immediately after eating, elevating the head of the bed, and quitting smoking. These changes can help reduce the frequency and severity of symptoms.

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