[25F] With severe chest pain and confusion

Patient Description

A 25-year-old female has been experiencing severe chest pain (rated 7/10) that feels like it goes all the way through to her back for the past couple of weeks. The pain comes on suddenly, lasts at least 30 minutes or longer, and can occur at any time of the day without any specific triggers. There are no known activities or situations that alleviate the pain. Additionally, she has been feeling confused, like her head is under water, for the same duration, which is significantly affecting her daily activities and overall well-being. She reports shortness of breath, dizziness, lightheadedness, a fast heartbeat at times, and sweating or clamminess during the episodes of chest pain. There is no nausea or vomiting. Her medical history includes anemia and asthma, both diagnosed at age 7. She is allergic to aspirin and penicillin and is not currently taking any medications. She vapes nicotine and smokes marijuana but does not have a personal or family history of heart disease or other cardiovascular conditions. Recent diagnostic tests, including an EKG and a chest X-ray, were normal.

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Arora's Assessment

What might be happening

Based on the symptoms you've described, there are several serious conditions that could be causing your chest pain and confusion. Here are the most likely explanations:

  1. Heart Attack (Myocardial Infarction): Given your severe chest pain that radiates to your back, shortness of breath, sweating, and fast heartbeat, a heart attack is a serious possibility. Heart attacks can occur even in young individuals, especially if there are risk factors like smoking or vaping.

  2. Pulmonary Embolism: This is a condition where a blood clot travels to the lungs, causing chest pain, shortness of breath, and dizziness. It can be life-threatening and requires immediate medical attention.

  3. Aortic Dissection: This is a serious condition where there is a tear in the wall of the aorta, the main artery carrying blood from the heart. It can cause severe chest pain that radiates to the back and can be fatal if not treated promptly.

  4. Severe Asthma Attack: Given your history of asthma, a severe asthma attack could also cause chest pain and shortness of breath. However, the confusion and other symptoms make this less likely.

  5. Anemia-Related Complications: Severe anemia can sometimes cause chest pain and confusion due to reduced oxygen delivery to the heart and brain.

What you can do

  1. Seek Immediate Medical Attention: Given the severity and duration of your symptoms, you should seek immediate medical attention. Go to the nearest emergency room or call 911. Do not drive yourself; have someone else take you or call an ambulance.

  2. Describe Your Symptoms Clearly: When you arrive at the hospital, make sure to describe all your symptoms, including the chest pain, confusion, shortness of breath, dizziness, and sweating. Mention your history of anemia and asthma, as well as your allergies to aspirin and penicillin.

  3. Avoid Physical Exertion: Until you receive medical attention, try to stay calm and avoid any physical exertion that could worsen your symptoms.

  4. Follow Up: After receiving initial treatment, make sure to follow up with your healthcare provider for further evaluation and management of your condition.

Remember, I am not a doctor, and this information is not a substitute for professional medical advice. Please seek care from real health professionals to receive a formal diagnosis and appropriate treatment.

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4 mo ago

People Also Ask

What are the common symptoms of a heart attack in young individuals?

Common symptoms of a heart attack in young individuals can include severe chest pain that may radiate to the back, shortness of breath, sweating, a fast heartbeat, dizziness, and sometimes confusion. These symptoms can occur even without a family history of heart disease, especially if there are lifestyle risk factors like smoking or vaping.

How can vaping and smoking marijuana affect heart health?

Vaping and smoking marijuana can negatively affect heart health by increasing heart rate and blood pressure, which can contribute to cardiovascular problems. They can also lead to inflammation and oxidative stress, potentially increasing the risk of heart attacks or other heart-related issues.

What is a pulmonary embolism and what are its symptoms?

A pulmonary embolism is a blockage in one of the pulmonary arteries in the lungs, usually caused by blood clots that travel from the legs or other parts of the body. Symptoms include sudden chest pain, shortness of breath, dizziness, and sometimes a fast heartbeat. It is a serious condition that requires immediate medical attention.

How does anemia contribute to symptoms like chest pain and confusion?

Anemia can lead to symptoms like chest pain and confusion because it results in a reduced number of red blood cells or hemoglobin, which means less oxygen is delivered to the body's tissues, including the heart and brain. This can cause the heart to work harder and lead to symptoms like fatigue, dizziness, and confusion.

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