[25M] With intermittent chest pain and systemic symptoms

Patient Description

A 25-year-old male reports experiencing intermittent chest pain for several years. The pain varies in sensation, sometimes sharp and other times feeling like a shock, with a severity rating of 2 out of 10. Episodes last approximately 30 seconds and occur a few times a day. The pain is not exacerbated by any specific activities and is alleviated by lying down. Accompanying symptoms include fluctuations in body temperature (feeling very cold or very hot), dizziness, fatigue, shakiness, loss of sensation, nausea, vomiting, and persistent exhaustion, which have significantly impacted his lifestyle. There is no history of injuries contributing to the weakness, and the sensation of being unusually hot is a new experience for the patient.

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Arora's Assessment

What might be happening

Based on the symptoms you've described, there are a few potential explanations for what you might be experiencing. It's important to remember that these are just possibilities, and you should consult a healthcare professional for a formal diagnosis.

  1. Anxiety or Panic Disorder: The intermittent chest pain, dizziness, and sensations of being very hot or cold could be related to anxiety or panic attacks. These conditions can cause physical symptoms that mimic other medical issues, including chest pain and dizziness.

  2. Fibromyalgia: This condition is characterized by widespread musculoskeletal pain, fatigue, and tenderness in localized areas. Your joint pain, exhaustion, and overall body pain could be related to fibromyalgia.

  3. Chronic Fatigue Syndrome (CFS): Given your constant exhaustion and weakness, CFS could be a possibility. It often presents with severe fatigue, joint pain, and dizziness.

  4. Autonomic Dysfunction: This can cause symptoms like dizziness, feeling hot or cold, and fatigue. It involves the part of the nervous system that controls involuntary actions, and can sometimes lead to symptoms like those you're experiencing.

What you can do

Chest Pain and Dizziness:

  • It's important to consult a healthcare provider to rule out any serious conditions, especially related to the heart. They may recommend tests like an ECG or stress test.
  • Practice relaxation techniques such as deep breathing or meditation to help manage anxiety-related symptoms.

Exhaustion and Weakness:

  • Ensure you are getting adequate rest and maintaining a regular sleep schedule.
  • Consider keeping a symptom journal using MDandMe to track your energy levels and identify any potential triggers.

Joint Pain:

  • Gentle exercises, such as stretching or yoga, can help maintain joint flexibility and reduce pain.
  • Over-the-counter pain relief, like ibuprofen, may help alleviate some discomfort, but consult with a healthcare provider for long-term management strategies.

What you should look out for

While your symptoms are concerning, they do not appear to be immediately life-threatening. However, you should seek medical attention if you experience:

  • Sudden, severe chest pain or pressure, especially if it radiates to your arm, neck, or jaw.
  • Fainting or severe dizziness.
  • Any new or worsening symptoms.

Remember, it's important to consult with a healthcare professional to receive a proper diagnosis and treatment plan. They can provide guidance tailored to your specific situation.

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26 d ago


People Also Ask


What could be causing intermittent chest pain in a young adult?

Intermittent chest pain in a young adult can be caused by a variety of factors, including anxiety or panic disorders, musculoskeletal issues, or even gastrointestinal problems. It's important to consult a healthcare provider to rule out any serious conditions, especially those related to the heart.


How can anxiety or panic disorders manifest physically?

Anxiety or panic disorders can manifest physically with symptoms such as chest pain, dizziness, sweating, shaking, and sensations of being very hot or cold. These symptoms can mimic other medical conditions, which is why a proper diagnosis is important.


What are the common symptoms of Chronic Fatigue Syndrome (CFS)?

Common symptoms of Chronic Fatigue Syndrome (CFS) include severe fatigue that doesn't improve with rest, joint pain, dizziness, headaches, and difficulty concentrating. The condition can significantly impact daily activities and quality of life.


What is autonomic dysfunction and how does it affect the body?

Autonomic dysfunction involves the part of the nervous system that controls involuntary actions, such as heart rate, blood pressure, and digestion. It can cause symptoms like dizziness, feeling very hot or cold, fatigue, and sometimes even fainting. Diagnosis and management often require a specialist's input.


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