[23M] Experiencing sharp chest discomfort with palpitations

Patient Description

A 23-year-old male reports sharp, severe discomfort on the right side of the chest, described as a sensation of something moving in and out, causing palpitations. These symptoms began today and have not been experienced before. The palpitations are somewhat regular, lasting a few seconds to a minute, and occurred after waking up in the middle of the night. The patient feels slightly feverish but has no cough, dizziness, lightheadedness, shortness of breath, or radiating chest pain. There is a history of H. Pylori diagnosed 5 years ago, with a noted adverse reaction to treatment causing constipation and bloody stool. The patient also had pneumonia over a decade ago and currently has a morning runny nose. No recent caffeine or alcohol consumption was reported, and the patient is not on any medications. There is no known family history of heart-related problems, and no other symptoms were reported at this time.

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Arora's Assessment

What might be happening

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

  • Anxiety or Stress: Anxiety or stress can sometimes cause physical symptoms like palpitations. You mentioned feeling a little stressed, which could be contributing to your symptoms.

    • Treatment typically involves lifestyle changes, therapy, and sometimes medication.
  • Gastroesophageal Reflux Disease (GERD): This is a digestive disorder that affects the ring of muscle between your esophagus and your stomach. It can cause a sensation of a lump or something stuck in the chest, which could be interpreted as palpitations.

    • Treatment typically involves lifestyle changes and over-the-counter medications. In severe cases, prescription medication or surgery may be needed.
  • Costochondritis: This is inflammation of the cartilage in the rib cage. It usually occurs in the cartilage where the upper ribs attach to the breastbone (sternum), an area known as the costosternal joint. This could explain the localized discomfort in your right chest.

    • Treatment typically involves pain relievers such as nonsteroidal anti-inflammatory drugs (NSAIDs), physical therapy, and possibly corticosteroid injections.

Please note that these are just possibilities and not a definitive diagnosis. It's important to consult with a healthcare provider for an accurate diagnosis.

What you can do

Here are some steps you can take:

  1. Try to reduce stress and anxiety: Practice relaxation techniques such as deep breathing, meditation, and yoga. Regular physical activity and a healthy diet can also help.

  2. Lifestyle changes for GERD: Try to identify and avoid foods that trigger your symptoms. Eat smaller meals and avoid eating before bedtime. Elevate the head of your bed if you're experiencing heartburn at night.

  3. Rest and avoid strenuous activity: If your symptoms are due to costochondritis, rest and avoiding strenuous activity may help to reduce inflammation.

What you should look out for

Please seek immediate medical attention if you experience any of the following:

  • Severe chest pain or pressure, especially if it radiates to your arm, jaw, or back
  • Shortness of breath
  • Sweating
  • Nausea or vomiting
  • Dizziness or fainting
  • Pain that worsens with physical activity or stress

Remember, I'm an AI and this advice is not a substitute for professional medical advice. Please consult with a healthcare provider for an accurate diagnosis.

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10 mo ago

People Also Ask


What are common causes of chest palpitations in young adults?

Common causes of chest palpitations in young adults include stress, anxiety, caffeine or alcohol consumption, lack of sleep, and sometimes underlying medical conditions like arrhythmias or thyroid issues. It's important to consult a healthcare provider for a proper evaluation.


How can stress and anxiety lead to physical symptoms like palpitations?

Stress and anxiety can trigger the body's 'fight or flight' response, releasing adrenaline and other stress hormones that can cause physical symptoms such as palpitations, increased heart rate, and a sensation of chest discomfort.


What lifestyle changes can help manage symptoms of GERD?

Lifestyle changes to manage GERD include avoiding trigger foods (such as spicy or fatty foods), eating smaller meals, not lying down immediately after eating, elevating the head of the bed, and maintaining a healthy weight. Over-the-counter medications like antacids may also help.


What is costochondritis and how is it treated?

Costochondritis is an inflammation of the cartilage that connects the ribs to the breastbone. It can cause sharp chest pain and discomfort. Treatment typically involves rest, pain relievers like NSAIDs, physical therapy, and in some cases, corticosteroid injections to reduce inflammation.


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