[22F] Experiencing chest tightness, shortness of breath, and swollen throat

Patient Description

A 22-year-old female presents with a 2-day history of chest tightness described as a constant pressure across the whole upper chest, which has worsened today. The patient reports that the tightness is exacerbated when lying down and is not relieved by any measures. Additionally, there is an associated odd feeling in the stomach described as tension, rated at a severity of 5 out of 10, which has been present for a few hours. The patient also experiences facial tingling. The patient's last bowel movement was at 5 pm and was mostly normal. The patient is unsure about the presence of fever or chills. No pregnancy is reported.

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Arora's Assessment

What might be happening

Based on the symptoms you've described, here are a few possibilities:

  • Anxiety or Panic Disorder: These conditions can cause physical symptoms like chest tightness, shortness of breath, and a feeling of a lump in the throat. Anxiety can also cause stomach discomfort and tingling in the face or other parts of the body.

    • Treatment often involves cognitive-behavioral therapy, relaxation techniques, and sometimes medication.
  • Gastroesophageal Reflux Disease (GERD): This condition occurs when stomach acid frequently flows back into the tube connecting your mouth and stomach (esophagus). This backwash (acid reflux) can irritate the lining of your esophagus and cause chest discomfort.

    • Treatment often involves lifestyle changes and over-the-counter medications. In severe cases, prescription medications or surgery might be necessary.
  • Heart conditions: Although less likely given your age and gender, heart conditions can cause chest tightness and shortness of breath. Conditions like angina or even a heart attack could present with these symptoms.

    • Treatment depends on the specific heart condition, but it's important to seek immediate medical attention if a heart condition is suspected.

What you can do

  1. If your symptoms are severe or worsening, seek immediate medical attention. Chest pain and shortness of breath can be signs of serious conditions.
  2. Try to relax and take slow, deep breaths. If your symptoms are due to anxiety, this may help.
  3. Avoid triggers that may worsen your GERD symptoms, such as fatty or fried foods, tomato sauce, alcohol, chocolate, mint, garlic, onion, and caffeine.
  4. Over-the-counter antacids may help with your GERD symptoms.

What you should look out for

Seek immediate medical attention if:

  • Your chest pain is severe, especially if you also have pain in your arm or jaw, shortness of breath, sweating, nausea, dizziness or fainting.
  • You have severe difficulty breathing.
  • You cough up blood.
  • You feel like your throat is closing up or you're choking.
  • You have a high fever, confusion, or a stiff neck.

Remember, I'm an AI and this advice is based on the symptoms you've told me. It's always important to consult with a healthcare professional for an accurate diagnosis.

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11 mo ago

People Also Ask


What are common symptoms of anxiety or panic disorders?

Common symptoms of anxiety or panic disorders include chest tightness, shortness of breath, a feeling of a lump in the throat, stomach discomfort, tingling sensations, and a rapid heartbeat. These symptoms can vary in intensity and duration.


How can GERD cause chest tightness and what are some lifestyle changes to manage it?

GERD can cause chest tightness due to acid reflux irritating the esophagus. Lifestyle changes to manage GERD include avoiding trigger foods like fatty or fried foods, alcohol, and caffeine, eating smaller meals, not lying down immediately after eating, and maintaining a healthy weight.


What are the warning signs of a heart condition that require immediate medical attention?

Warning signs of a heart condition that require immediate medical attention include severe chest pain, pain radiating to the arm or jaw, shortness of breath, sweating, nausea, dizziness, fainting, and a feeling of choking or throat closing.


Can facial tingling be related to anxiety or other conditions?

Facial tingling can be related to anxiety as it can cause hyperventilation and changes in blood flow, leading to tingling sensations. It can also be associated with other conditions like migraines, nerve issues, or vitamin deficiencies, so it's important to consult a healthcare professional for an accurate diagnosis.


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