[22F] Experiencing joint pain, chest pain, and other symptoms

Patient Description

A 22-year-old female presents with a history of joint pain in the knees and ankles, described as throbbing and aching, most severe in the mornings and evenings, and ongoing for seven years. The patient suspects a torn meniscus in the left knee. Additionally, she experiences chest pain during workouts, characterized as a burning and throbbing sensation that resolves upon cessation of exercise. The patient reports an abnormally high heart rate during physical activity, with a resting heart rate of 50-58 bpm that increases to 200-220 bpm during exercise. Mental fog and constant fatigue have been affecting her university performance for the past five years. The patient has a history of kidney issues, including chronic kidney infections and a decrease in GFR from 109 to 88. One pupil is more dilated than the other, and she has been experiencing moderate overlapping double vision for two years, which impairs driving and recognition of faces. The patient also suffers from severe eye pain associated with migraines and has extreme thirst. She has a family history of multiple sclerosis, diabetes, and lupus. Known allergies include anaphylactic reactions to pollen and hives from Tylenol. The patient is currently taking Lamictal 100 mg daily and has been diagnosed with anaphylactic reactions to pollen since 2013.

Arora's Assessment

What might be happening

Based on the information you've provided, several conditions could be causing your symptoms:

Autoimmune or Connective Tissue Disease: Given your family history of multiple sclerosis and lupus, and your symptoms of joint pain and fatigue, you may be experiencing an autoimmune or connective tissue disease. These conditions occur when your immune system mistakenly attacks your own body tissues.
- Common treatments include medications to suppress the immune system and manage symptoms.
Cardiovascular Condition: Your chest pain during exercise and high heart rate could be signs of a cardiovascular condition, such as angina or arrhythmia.
- Angina is typically managed with medications, lifestyle changes, and sometimes surgical procedures. Arrhythmias may be managed with medications, medical procedures, or implantable devices, depending on their severity.
Kidney Disease: Your history of kidney problems, decreased GFR, and symptoms of extreme thirst and frequent urination could indicate chronic kidney disease.
- Treatment typically involves addressing the underlying cause, managing symptoms, and preventing progression of the disease.
Neurological Condition: Your symptoms of double vision, one pupil more dilated than the other, and mental fog could be signs of a neurological condition.
- Treatment would depend on the specific condition and could include medications, physical therapy, or surgery.

What you can do

You should seek immediate medical attention given your symptoms. Here are some steps you can take:

Schedule an appointment with your primary care doctor. They can perform a physical examination and order necessary tests.
If your chest pain becomes severe, seek immediate medical attention.
Keep a symptom diary. Note when each symptom occurs, its severity, and any potential triggers. This can help your doctor make a diagnosis.
Stay hydrated and maintain a balanced diet. This can help manage your symptoms and overall health.

What you should look out for

Seek immediate medical attention if you experience:

Severe chest pain
Difficulty breathing
Severe abdominal pain
Blood in your urine
Sudden, severe headache
Sudden difficulty speaking or understanding speech
Sudden weakness or numbness, especially on one side of the body

Please remember that while I strive to provide accurate information, I'm an AI and not a doctor. Always consult with a healthcare professional for a formal diagnosis and treatment.

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1 yr ago

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