[25F] Experiencing chest pain, hallucinations, skin rash, and nausea

Patient Description

A 25-year-old female has been experiencing dull chest pain that worsens with breathing for the past week, rated at a severity of 5 out of 10. Additionally, she has been having hallucinations of seeing things in her peripheral vision that aren't there, along with random episodes of nausea rated at a severity of 7 out of 10, both for the past three months. She also reports a skin rash consisting of small, round, dry patches on her thighs, legs, and hands, present for three months. The patient has noticed some weight loss recently. She is currently taking Metformin and has no known allergies or adverse reactions to medications. There are no pre-existing conditions or chronic illnesses reported.

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Arora's Assessment

What might be happening

Based on the information you have provided, possible diagnoses include:

  • Costochondritis: This condition causes chest pain that can be severe. It is caused by inflammation of the cartilage in the chest wall. Symptoms include pain and tenderness in the areas where your ribs attach to your breastbone. The pain can worsen when you take a deep breath or cough.

    • Treatment typically involves pain relievers such as nonsteroidal anti-inflammatory drugs (NSAIDs) and rest.
  • Anxiety Disorders: Anxiety can cause physical symptoms like the ones you're experiencing, including chest pain, nausea, and hallucinations.

    • Treatment typically involves psychotherapy (talk therapy), medications, or both.
  • Dermatitis: This is a common condition that causes dry, itchy skin. It can occur in small patches on the body.

    • Treatment typically involves moisturizing regularly and using medicated creams or ointments.

However, it's important to note that these are just possibilities based on the information you've provided. You should seek care from a healthcare professional to receive a formal diagnosis and appropriate treatment.

What you can do

  1. For the chest pain, try to rest and avoid activities that make it worse. Over-the-counter pain relievers may help.
  2. For the skin rash, try applying a moisturizer or over-the-counter hydrocortisone cream. Avoid scratching the affected areas.
  3. For the hallucinations and nausea, it may be helpful to practice relaxation techniques such as deep breathing, meditation, or yoga. However, you should seek immediate medical attention if these symptoms persist or worsen.
  4. Keep a symptom diary. Note down when each symptom occurs, its severity, and any potential triggers. This can be helpful information for your doctor.

What you should look out for

Seek immediate medical attention if:

  • Your chest pain becomes severe or is accompanied by other symptoms such as difficulty breathing, pain radiating to your jaw or left arm, or if it is associated with exercise.
  • Your hallucinations become more frequent or severe, or if they start to affect your daily life.
  • Your skin rash spreads, becomes more painful, or is accompanied by other symptoms such as fever.
  • Your nausea becomes severe or is accompanied by vomiting, especially if you are unable to keep down fluids.

Remember, it's important to consult with a healthcare professional who can evaluate your symptoms and condition in person. This advice is intended to be general in nature, and specific causes may not apply to your situation. Always seek medical attention for severe or worrying symptoms.

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1 yr ago

People Also Ask


What could be causing my chest pain that worsens with breathing?

Chest pain that worsens with breathing could be caused by costochondritis, which is inflammation of the cartilage in the chest wall. It can also be related to anxiety or other conditions. It's important to consult a healthcare professional for an accurate diagnosis.


Are hallucinations in peripheral vision a common symptom of anxiety?

Yes, anxiety can sometimes cause hallucinations, including seeing things in peripheral vision that aren't there. However, it's important to discuss these symptoms with a healthcare provider to rule out other causes.


What are some effective treatments for dermatitis with dry patches on the skin?

Effective treatments for dermatitis include regular moisturizing and the use of medicated creams or ointments, such as hydrocortisone. Avoiding irritants and keeping the skin hydrated can also help manage symptoms.


Can Metformin cause weight loss and nausea as side effects?

Metformin can cause gastrointestinal side effects, including nausea, which might lead to weight loss. If these symptoms are severe or persistent, it's important to discuss them with a healthcare provider.


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