[24F] Experiencing chest pain and tightness

Patient Description

A 24-year-old female has been experiencing chest pain and tightness for a few weeks, with worsening symptoms last night. The pain is typically dull but occasionally sharp, lasting from 10 minutes to over an hour, and occurs more frequently in the evenings and at night. Sitting down provides relief. The patient also reports tightness in the chest and left shoulder, headaches, and episodes of a racing heart multiple times a week, lasting 10 minutes to an hour. She experiences palpitations, occasional shortness of breath, chills, and occasional coughing without changes in frequency or severity. The patient vapes nicotine daily and uses a Ventolin inhaler as needed, along with taking birth control, vitamin D, and iron supplements. There is no known history of heart conditions, high blood pressure, or family history of heart disease.

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Arora's Assessment

What might be happening

Based on your symptoms, here are some possible explanations:

  • Anxiety or Panic Attacks: Stress and anxiety can cause chest tightness, racing heart, and chills. These episodes can occur suddenly and may be more frequent at night.

    • Treatment often involves stress management techniques, therapy, and sometimes medication.
  • Musculoskeletal Pain: Pain in the chest and shoulder could be related to muscle strain or tension, especially if relieved by rest.

    • Treatment includes rest, over-the-counter pain relievers, and gentle stretching.
  • Asthma or Respiratory Issues: Given your use of an inhaler, asthma could contribute to chest tightness and coughing.

    • Treatment involves using your inhaler as prescribed and avoiding triggers.
  • Gastroesophageal Reflux Disease (GERD): This can cause chest pain and tightness, especially at night.

    • Treatment includes dietary changes, antacids, and avoiding eating before bed.

What you can do

  • Relaxation Techniques: Practice deep breathing, meditation, or yoga to help manage stress and anxiety.
  • Monitor Symptoms: Keep a journal of your symptoms using MDandMe to track patterns and triggers.
  • Lifestyle Adjustments: Avoid vaping, as it can exacerbate respiratory issues. Consider discussing cessation options with a healthcare provider.
  • Consult a Doctor: It's important to see a healthcare professional for a proper diagnosis and treatment plan.

What you should look out for

Seek medical attention if you experience:

  • Severe or worsening chest pain
  • Difficulty breathing
  • Fainting or dizziness
  • New or worsening symptoms

Remember, this information is not a substitute for professional medical advice. Please consult a healthcare provider for a formal diagnosis and treatment.

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3 mo ago

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People Also Ask


Can anxiety or panic attacks cause chest pain and a racing heart?

Yes, anxiety or panic attacks can cause symptoms such as chest pain, tightness, and a racing heart. These symptoms can occur suddenly and are often more frequent during periods of stress or at night.


How can musculoskeletal pain lead to chest and shoulder discomfort?

Musculoskeletal pain, such as muscle strain or tension, can cause discomfort in the chest and shoulder area. This type of pain is often relieved by rest and can be managed with over-the-counter pain relievers and gentle stretching.


What are the symptoms of asthma that might overlap with other conditions?

Asthma symptoms can include chest tightness, coughing, shortness of breath, and wheezing. These symptoms can overlap with other conditions, making it important to use inhalers as prescribed and avoid known triggers.


How does gastroesophageal reflux disease (GERD) cause chest pain, especially at night?

GERD can cause chest pain and tightness due to stomach acid refluxing into the esophagus, especially when lying down at night. This can be managed with dietary changes, antacids, and avoiding eating before bed.


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