[27F] Experiencing shortness of breath, upper back pain, and swollen lymph node

Patient Description

A 27-year-old female presents with shortness of breath that is rated 4 out of 10 in severity, has been ongoing for 5 days, and is not relieved by any specific actions. This symptom has recurred after a couple of months of absence. The patient also reports a pressure-like pain in the middle upper back that started 1 day ago, worsening in the afternoon, and is rated 5 out of 10 in severity. Additionally, the patient has a swollen lymph node on the upper back of the neck on the right side, which has been present for 6 months and is described as tender and a little hard. The patient experiences chest tightness in the middle of the chest and joint ankle pain but has not noticed any recent weight changes or coughed up blood. No recent use of hormonal contraceptives, tobacco products, or recreational drugs. The patient's medical history is unremarkable, with no known allergies or adverse reactions to medications, and is currently taking vitamins B12 and D.

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Arora's Assessment

What might be happening

Based on the symptoms you've described, there are a few possible conditions that could be causing your symptoms:

  • Pulmonary Embolism: This is a blockage in one of the pulmonary arteries in your lungs. In most cases, pulmonary embolism is caused by blood clots that travel to the lungs from the legs or, rarely, other parts of the body (deep vein thrombosis). It can cause shortness of breath, chest pain, and upper back pain.

    • Diagnosis usually involves imaging studies like a CT scan or a VQ scan. Treatment typically involves anticoagulant medications to prevent further clotting.
  • Pneumonia: This is an infection that inflames the air sacs in one or both lungs. The air sacs may fill with fluid or pus (purulent material), causing cough with phlegm or pus, fever, chills, and difficulty breathing.

    • Diagnosis is usually confirmed with a chest X-ray. Treatment typically involves antibiotics and supportive care.
  • Pleurisy: This is an inflammation of the lining of the lungs and chest (the pleura) that leads to chest pain (usually sharp) when you take a breath or cough.

    • Diagnosis is usually based on the symptoms and physical examination. Treatment typically involves addressing the underlying cause and pain management.

The swollen lymph node could be due to a variety of causes, including infection, autoimmune diseases, or in rare cases, cancers such as lymphoma. However, it's important to note that these are just possibilities and not a definitive diagnosis.

What you can do

Given the severity and nature of your symptoms, it's important that you seek immediate medical attention. These symptoms could indicate a serious condition that needs to be evaluated and treated by a healthcare professional.

What you should look out for

You should seek immediate medical attention if you experience any of the following:

  • Severe chest pain
  • Severe difficulty breathing
  • Coughing up blood
  • High fever
  • Rapid heart rate or palpitations

Please remember that while I strive to provide accurate information, I am not a doctor and this advice should not replace a consultation with a healthcare professional.

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1 yr ago

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People Also Ask


What are the common symptoms of a pulmonary embolism?

Common symptoms of a pulmonary embolism include sudden shortness of breath, chest pain that may become worse when you breathe deeply or cough, and a cough that may produce bloody or blood-streaked sputum. Other symptoms can include rapid heart rate, dizziness, or leg pain/swelling.


How is pneumonia diagnosed and treated?

Pneumonia is typically diagnosed with a physical examination and confirmed with a chest X-ray. Blood tests and sputum cultures may also be used to identify the cause. Treatment usually involves antibiotics if it's bacterial, rest, fluids, and over-the-counter medications to manage symptoms.


What could cause a swollen lymph node in the neck?

A swollen lymph node in the neck can be caused by infections (such as a cold or sore throat), autoimmune diseases, or, less commonly, cancers like lymphoma. Persistent swelling should be evaluated by a healthcare professional.


When should someone seek immediate medical attention for chest pain?

Immediate medical attention for chest pain is necessary if the pain is severe, accompanied by difficulty breathing, radiates to the arms, neck, or jaw, or is associated with symptoms like sweating, nausea, or a rapid heartbeat. These could be signs of a serious condition such as a heart attack or pulmonary embolism.


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