[24F] with multiple symptoms including headache and chest pain

Patient Description

A 24-year-old female presents with multiple symptoms including lines on the arms, redness of the fingers, pain in the lower right arm, chest pain, and a heavy feeling in the head, particularly behind the ears and sometimes in the front. The patient also reports a sensation of ants crawling when crossing legs, cold feet, and a warm neck. The most bothersome symptom is a headache described as a pressure rated 8 out of 10, which has been present for a week and worsens when sitting but improves with walking. This is the first occurrence of these symptoms.

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Arora's Assessment

What might be happening

Based on the symptoms you've described, here are some possible explanations:

  1. Tension Headache:

    • Rationale: The feeling of pressure in your head, especially when sitting, is a common symptom of tension headaches. These headaches can be triggered by stress, poor posture, or muscle strain.
    • Typical Treatments: Over-the-counter pain relievers like ibuprofen or acetaminophen, stress management techniques, and improving posture can help alleviate symptoms.
  2. Cervicogenic Headache:

    • Rationale: This type of headache originates from issues in the neck and can cause a heavy feeling in the head. The fact that your neck feels warm and your feet cold might indicate a problem with blood flow or nerve function in the neck area.
    • Typical Treatments: Physical therapy, neck exercises, and sometimes medications or injections to relieve pain and inflammation.
  3. Peripheral Neuropathy:

    • Rationale: The sensation of ants crawling when crossing your legs and the cold feet could be signs of peripheral neuropathy, which affects the nerves outside the brain and spinal cord.
    • Typical Treatments: Managing underlying conditions (like diabetes), medications to relieve nerve pain, and lifestyle changes.
  4. Cardiovascular Issues:

    • Rationale: Chest pain and cold feet can sometimes be related to cardiovascular issues. It's important to rule out serious conditions like angina or other heart-related problems.
    • Typical Treatments: Immediate medical evaluation, lifestyle changes, medications, and sometimes surgical interventions.

What you can do

For the heavy head and headache:

  • See a doctor: Given the severity (8/10) and the new onset of your symptoms, it's important to consult a healthcare provider to rule out serious conditions.
  • At home:
    • Practice good posture, especially when sitting.
    • Use over-the-counter pain relievers as directed.
    • Apply a warm or cold compress to your neck and shoulders.

For chest pain:

  • See a doctor immediately: Chest pain can be a sign of a serious condition like a heart attack. Seek medical attention as soon as possible.
  • At home: Avoid strenuous activities and try to stay calm until you can see a healthcare provider.

For the sensation of ants crawling and cold feet:

  • See a doctor: These symptoms could be related to nerve issues or circulation problems. A healthcare provider can help determine the cause.
  • At home:
    • Keep your feet warm with socks or a warm foot bath.
    • Avoid crossing your legs for long periods.

For finger redness and arm pain:

  • See a doctor: Persistent pain and redness could indicate an underlying issue that needs medical attention.
  • At home:
    • Rest your arms and avoid activities that worsen the pain.
    • Apply ice to reduce inflammation and take over-the-counter pain relievers if needed.

What you should look out for

Given the range of your symptoms, it's important to seek medical care to get a comprehensive evaluation. Reasons to seek care urgently include:

  • Worsening chest pain or shortness of breath.
  • Severe or sudden headache.
  • Numbness or weakness in your limbs.
  • Any new or worsening symptoms.

Remember, while I can provide some guidance, it's crucial to consult with a healthcare professional for a formal diagnosis and appropriate treatment. You can also use MDandMe to journal your symptoms, track progress, get insights, and share longitudinal medical notes with your provider.

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6 mo ago

People Also Ask


What are the common causes of tension headaches?

Tension headaches are often caused by stress, poor posture, muscle strain, or fatigue. They are characterized by a feeling of pressure or tightness around the forehead or back of the head and neck.


How can cervicogenic headaches be distinguished from other types of headaches?

Cervicogenic headaches are typically associated with neck pain and stiffness. They often originate from issues in the cervical spine and can be triggered by neck movements or sustained postures. Unlike migraines, they usually do not have associated symptoms like nausea or visual disturbances.


What are the symptoms and causes of peripheral neuropathy?

Peripheral neuropathy is characterized by symptoms such as tingling, numbness, and a sensation of ants crawling on the skin. It can be caused by diabetes, infections, injuries, or exposure to toxins. It affects the nerves outside the brain and spinal cord.


When should chest pain be considered an emergency?

Chest pain should be considered an emergency if it is severe, sudden, or accompanied by symptoms like shortness of breath, sweating, nausea, or pain radiating to the arm or jaw. These could be signs of a heart attack or other serious cardiovascular issues.


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