[25F] With chronic chest pain and recent leg and arm aches
Patient Description
A 25-year-old female has been experiencing chest pain since 2015 or 2016. The pain can be both dull and sharp, rated as a 6 or 7 out of 10 in severity. The chest pain occurs almost every day, lasts only a couple of minutes but reoccurs, and comes on suddenly. No specific activities or situations make the pain worse, and nothing has been found to relieve it. The patient sometimes experiences palpitations and dizziness along with the chest pain but does not experience shortness of breath, swelling in the legs or ankles, nausea, vomiting, or sweating. An EKG showed a small arrhythmia. Stress and caffeine can sometimes trigger the chest pain and arrhythmia. The patient rarely drinks alcohol and has a family history of heart disease; specifically, the grandfather had open-heart surgery at a young age (mid-20s to 30s). The patient is allergic to amoxicillin and is currently taking Heather 5 MG progesterone-only birth control pills for almost a year. No other medications are being taken. Additionally, the patient has been experiencing dull and throbbing muscle pain in the legs and arms for the past 3-4 months, rated as a 3-4 out of 10 in severity. No injuries were reported before the pain started, nor has there been any recent travel or use of recreational drugs. The menstrual cycle has been irregular since the birth of the child, with periods sometimes being lighter and sometimes skipping a month, but no other symptoms related to the menstrual cycle have been noticed. The patient also has dull and throbbing pain in the left leg for the past 3 months, rated as a 3 out of 10 in severity. No exposure to environmental factors or toxins has been reported.
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Arora's Assessment
What might be happening
It is likely that your symptoms are related to multiple issues, including existing diagnoses. If you have more questions, we can continue chatting.
Causes of your chest pain, palpitations, and dizziness:
- Arrhythmia: Given your history of a small arrhythmia found on an EKG, this could be contributing to your chest pain, palpitations, and dizziness. Arrhythmias can cause irregular heartbeats, which may lead to these symptoms.
- Stress and Caffeine: Both stress and caffeine are known triggers for arrhythmias and can exacerbate chest pain and palpitations.
Causes of your dull and throbbing muscle pain in legs and arms:
- Pelvic Congestion Syndrome: This condition can cause chronic pelvic pain and may also contribute to leg pain due to varicose veins in the pelvic area.
- Chronic Venous Insufficiency: This condition can cause dull, throbbing pain in the legs due to poor blood flow and may be related to your pelvic congestion.
Irregular menstrual cycles:
- Hormonal Imbalance: Irregular periods, especially after childbirth, can be due to hormonal changes. The use of birth control pills like Heather can also influence menstrual regularity.
What you can do
Chest pain, palpitations, and dizziness:
- See a doctor: It's important to follow up with a healthcare provider to monitor your arrhythmia and discuss your chest pain and palpitations. They may recommend further testing or adjustments to your lifestyle or medications.
- Manage stress: Practice stress-reducing techniques such as deep breathing exercises, meditation, or yoga.
- Limit caffeine: Try to reduce your caffeine intake to see if it helps alleviate your symptoms.
Dull and throbbing muscle pain in legs and arms:
- Consult a healthcare provider: Discuss your symptoms with a doctor to rule out conditions like chronic venous insufficiency or other vascular issues.
- Compression stockings: Wearing compression stockings can help improve blood flow in your legs and reduce pain.
- Elevate your legs: When resting, try to keep your legs elevated to reduce swelling and discomfort.
Irregular menstrual cycles:
- Track your cycle: Keep a journal of your menstrual cycle, noting any irregularities, to discuss with your healthcare provider.
- Follow up with your doctor: Discuss your irregular periods and any concerns about your birth control method with your healthcare provider. They may suggest alternative options or further evaluation.
What you should look out for
Given the complexity of your symptoms, it's important to seek medical care to ensure a comprehensive evaluation. Reasons to seek care more urgently include:
- Worsening chest pain or new symptoms: If you experience severe chest pain, shortness of breath, fainting, or any new symptoms, seek immediate medical attention.
- Severe leg pain or swelling: If you notice significant swelling, redness, or warmth in your legs, it could indicate a more serious condition like a blood clot.
- Changes in symptoms: Any significant changes in your symptoms, such as increased frequency or severity, should be discussed with your healthcare provider.
Remember, while I can provide information and suggestions, it's crucial to consult with a real healthcare professional for a formal diagnosis and treatment plan. You can use MDandMe to journal your symptoms, track progress, get insights, and share longitudinal medical notes with your provider.
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3 mo ago