[27F] Experiencing sharp chest pain radiating to left shoulder

Patient Description

A 27-year-old female has been experiencing intermittent sharp chest pain for a few weeks, rating the pain as a 4 out of 10 in severity. The pain originates in the middle of the chest and radiates to the left shoulder, occurring both at rest and during physical activity. The pain is somewhat alleviated by changing body position. She has a history of palpitations but no other associated symptoms such as difficulty breathing, sweating, nausea, or vomiting. The patient has a family history of cardiac disease and a personal medical history of Polycystic Ovary Syndrome (PCOS), for which she is taking Metformin (500mg daily) and an unspecified birth control pill. She reports an allergy to sulfa drugs.

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Arora's Assessment

What might be happening

Based on the information you've provided, the following conditions could be causing your symptoms:

  • Musculoskeletal pain: This is a common cause of chest pain and can be caused by strain or inflammation of the muscles and tendons between the ribs. This type of pain can often be felt in the shoulder and can be affected by body position.

    • Treatment typically involves rest, over-the-counter pain relievers, and physical therapy exercises.
  • Gastroesophageal reflux disease (GERD): This is a condition where stomach acid frequently flows back into the tube connecting your mouth and stomach (esophagus). This backwash (acid reflux) can irritate the lining of your esophagus and cause chest pain.

    • Treatment typically involves lifestyle changes and over-the-counter medications. If these don't help, your doctor might recommend prescription medications or surgery.
  • Heart conditions: Given your family history of heart disease, conditions such as angina or a heart attack could potentially be causing your symptoms. These conditions typically cause chest pain that may radiate to the arm or shoulder, and may be associated with other symptoms like shortness of breath, sweating, nausea, or lightheadedness.

    • Treatment for heart conditions can vary widely depending on the specific condition and its severity, but may include medications, lifestyle changes, or surgical procedures.

What you can do

Given the potential seriousness of some of these conditions, particularly those related to the heart, it's important that you seek medical attention as soon as possible. A healthcare professional will be able to evaluate your symptoms, perform any necessary tests, and determine the most appropriate treatment for your condition.

In the meantime, try to rest and avoid any activities that seem to worsen your symptoms. If your pain is severe or if you experience any additional symptoms such as difficulty breathing, call for emergency medical help immediately.

What you should look out for

Seek immediate medical attention if you experience any of the following symptoms:

  • Severe chest pain
  • Chest pain accompanied by shortness of breath, sweating, dizziness, or nausea
  • Chest pain that spreads to your jaw, left arm, or back
  • Sudden sharp chest pain with shortness of breath, especially if you have been inactive or are under a lot of stress
  • New, unexplained chest pain

Remember, it's important to consult with a healthcare professional for a formal diagnosis and treatment. This advice is intended to be general in nature, and specific causes may not apply to your situation. Always seek the advice of a healthcare provider for any questions you have regarding your medical condition.

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10 mo ago

People Also Ask


What are the common causes of chest pain in young adults?

Common causes of chest pain in young adults include musculoskeletal issues, gastroesophageal reflux disease (GERD), anxiety or panic attacks, and less commonly, heart-related issues such as angina. It's important to consult a healthcare provider to determine the specific cause.


How can musculoskeletal chest pain be distinguished from heart-related chest pain?

Musculoskeletal chest pain is often affected by body position and can be reproduced by pressing on the chest or moving the arms. Heart-related chest pain, such as angina, may occur with physical exertion or stress and is often accompanied by other symptoms like shortness of breath or sweating. A healthcare provider can perform tests to differentiate between the two.


What lifestyle changes can help manage GERD symptoms?

Lifestyle changes to manage GERD symptoms include avoiding foods and drinks that trigger reflux (such as spicy foods, alcohol, and caffeine), eating smaller meals, not lying down immediately after eating, maintaining a healthy weight, and quitting smoking. Elevating the head of the bed can also help reduce nighttime symptoms.


How does a family history of cardiac disease affect my risk of heart conditions?

A family history of cardiac disease can increase your risk of developing heart conditions. It's important to discuss your family history with your healthcare provider, who may recommend regular monitoring, lifestyle changes, or preventive measures to reduce your risk.


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