[23F] Experiencing chest pain, low blood pressure, and rash

Patient Description

A 23-year-old female presents with a one-week history of aching chest pain, rated 6/10 in severity, which worsens upon bending down or laying down, with no relief from changes in position. Additionally, she reports a new onset of a faint but irritating rash on her stomach, shortness of breath, lightheadedness, dizziness, and heart palpitations. She has no recent travel history or known contacts with similar symptoms. The patient is currently on Zoloft (150mg for a few years), Buspar (once daily for a year), and doxycycline. She has no known drug allergies but describes herself as generally sensitive. There is no significant past medical history of chronic illnesses or conditions.

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Arora's Assessment

What might be happening

Based on the information you've provided, possible diagnoses include:

  • Anxiety or Panic Disorder: Given your age, gender, and the medications you're taking (Zoloft and Buspar), it's possible that your symptoms might be related to anxiety or panic disorder. These conditions can cause symptoms like chest pain, shortness of breath, heart palpitations, and even skin rashes. However, they would not typically cause low blood pressure.

    • Treatment usually involves a combination of medication (like the ones you're already taking) and cognitive-behavioral therapy.
  • Side effects from your medications: Zoloft, Buspar, and doxycycline can all potentially cause chest pain, rash, and low blood pressure as side effects. It's important to discuss these symptoms with your doctor, who may adjust your medication regimen if necessary.

    • Treatment would involve adjusting the medication causing the side effects.
  • Heart conditions: Conditions like pericarditis or myocarditis can cause chest pain and other symptoms you've described. These are serious conditions that require immediate medical attention.

    • Treatment typically involves medications to reduce inflammation and manage symptoms, and in severe cases, hospitalization.
  • Lung conditions: Conditions such as pneumonia or pleurisy could potentially cause chest pain and shortness of breath. However, these would typically also cause additional symptoms like fever and cough, which you did not report.

    • Treatment typically involves antibiotics and rest.

What you can do

Given the severity of your symptoms, especially the chest pain and low blood pressure, it's important to seek immediate medical attention. While waiting for medical help:

  1. Try to stay calm. Sit down, take slow, deep breaths, and try to relax.
  2. If you have aspirin at home and are not allergic to it, consider taking a dose as it can help in case of certain heart conditions.
  3. Do not drive yourself to the hospital. Have someone else drive you or call an ambulance.

What you should look out for

If you experience any of the following symptoms, seek immediate medical help:

  • Severe chest pain or chest pain that spreads to your jaw, left arm, or back
  • Sudden sharp chest pain with shortness of breath, especially after a long period of inactivity
  • Chest pain associated with nausea, dizziness, rapid heart rate or rapid breathing, confusion, ashen color, or excessive sweating
  • Fainting or severe weakness
  • Rapid or irregular heartbeat

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

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1 yr ago

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People Also Ask


Can anxiety or panic disorders cause physical symptoms like chest pain and rashes?

Yes, anxiety or panic disorders can cause a range of physical symptoms, including chest pain, heart palpitations, shortness of breath, and sometimes skin rashes. These symptoms are due to the body's stress response.


What are common side effects of Zoloft, Buspar, and doxycycline?

Common side effects of Zoloft and Buspar include dizziness, drowsiness, dry mouth, and nausea. Doxycycline can cause stomach upset, diarrhea, and skin sensitivity. All three can potentially cause chest pain and rashes.


What are the symptoms of pericarditis or myocarditis, and why are they serious?

Pericarditis and myocarditis involve inflammation of the heart or its surrounding tissues, leading to symptoms like chest pain, shortness of breath, and fatigue. They are serious because they can affect heart function and require prompt medical treatment.


How can lung conditions like pneumonia or pleurisy cause chest pain and shortness of breath?

Lung conditions like pneumonia or pleurisy can cause chest pain due to inflammation of the lung tissue or the lining of the lungs. This pain often worsens with breathing or coughing and is usually accompanied by symptoms like fever and cough.


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