[22F] Experiencing sharp chest pain when lying down

Patient Description

A 22-year-old female is reporting sharp chest pain located under the left breast, which has been present for the last hour. The pain is exacerbated by lying down and movement, but somewhat alleviated by sitting up. The patient rates the pain as a 4 out of 10 in terms of severity. Accompanying symptoms include anxiety and shortness of breath, as well as possible palpitations. There is no radiation of pain to other areas, and no associated symptoms of sweating, nausea, or vomiting. The patient does not report any recent travel, prolonged immobility, or family history of blood clots. The patient feels tired, which may be attributed to the late hour (2 am). There is no mention of any pre-existing conditions, chronic illnesses, or other symptoms at this time.

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Arora's Assessment

What might be happening

Based on the information you've provided, here are a few possibilities:

  • Costochondritis: This is inflammation of the cartilage in your rib cage. The pain usually occurs in the cartilage where the upper ribs attach to the breastbone, or sternum. The pain can be sharp and is often worsened with movement or deep breathing.

    • Treatment typically involves rest, avoiding activities that make your pain worse, and over-the-counter pain relievers.
  • Anxiety: Anxiety can cause physical symptoms like chest pain, rapid heartbeat, and shortness of breath. It's possible that your chest pain is related to feelings of anxiety.

    • Treatment for anxiety often involves cognitive-behavioral therapy, medications, and lifestyle modifications like regular exercise, a healthy diet, and avoiding caffeine and alcohol.
  • Gastroesophageal reflux disease (GERD): This is a chronic condition where 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 pain.

    • Treatment often involves lifestyle changes and over-the-counter medications. In some cases, prescription medications or surgery might be needed.

Please note that these are just possibilities and not a definitive diagnosis.

What you can do

  1. Try to rest and avoid activities that worsen your pain.
  2. Over-the-counter pain relievers like ibuprofen can help with the pain.
  3. If you're feeling anxious, try deep breathing exercises or other relaxation techniques.
  4. If your pain might be related to GERD, try avoiding foods that trigger heartburn (like spicy foods, citrus, and caffeine), eat smaller meals, and don't lie down after eating.

What you should look out for

You should seek immediate medical attention if:

  • Your chest pain becomes severe or is accompanied by other symptoms such as pain radiating down your arm, jaw pain, sweating, or difficulty breathing.
  • You have a high fever or a cough that produces yellow-green phlegm.
  • You have a history of heart disease, high cholesterol, or high blood pressure.

Remember, I'm an AI and not a doctor. It's important to consult with a healthcare provider for an accurate diagnosis and treatment.

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1 yr ago

People Also Ask


What is costochondritis and how is it treated?

Costochondritis is an inflammation of the cartilage in the rib cage, often causing sharp pain where the ribs attach to the breastbone. Treatment typically involves rest, avoiding activities that worsen the pain, and taking over-the-counter pain relievers.


Can anxiety cause physical symptoms like chest pain?

Yes, anxiety can cause physical symptoms such as chest pain, rapid heartbeat, and shortness of breath. Treatment for anxiety often includes cognitive-behavioral therapy, medications, and lifestyle changes like regular exercise and a healthy diet.


What are the common symptoms and treatments for GERD?

GERD, or gastroesophageal reflux disease, is a condition where stomach acid frequently flows back into the esophagus, causing irritation and chest pain. Common treatments include lifestyle changes, over-the-counter medications, and in some cases, prescription medications or surgery.


When should I seek immediate medical attention for chest pain?

You should seek immediate medical attention if your chest pain becomes severe or is accompanied by symptoms like pain radiating down your arm, jaw pain, sweating, or difficulty breathing. Also, seek help if you have a high fever, a cough with yellow-green phlegm, or a history of heart disease.


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