[27F] With jaw pain, chest pain, and elevated WBC count

Patient Description

A 27-year-old female presents with sudden onset jaw pain, chest pain rated at 7/10, shortness of breath, tingling in the hands, and nausea persisting for two months. The patient reports fatigue and a recent change in her menstrual cycle. She has a family history of heart disease or stroke and has been smoking a pack of cigarettes daily for 10 years. Current medications include Bisoprolol 2.5 mg, Lisinopril 10 mg, Tylenol 500 mg, and ibuprofen 800 mg, all taken daily. The patient has a Nexplanon implant for birth control. She has not had recent infections, injuries, or significant stressors, nor has she undergone recent blood tests or medical evaluations for the elevated white blood cell count of 15.0. No known drug allergies or chronic illnesses reported.

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Arora's Assessment

What might be happening

Based on the symptoms you've described, there are several potential concerns that need immediate attention:

  1. Heart Attack (Myocardial Infarction): Your symptoms, including chest pain, jaw pain, shortness of breath, nausea, and tingling in the hands, are concerning for a possible heart attack. This is especially important given your family history of heart disease and smoking history. A heart attack occurs when blood flow to a part of the heart is blocked, and it requires immediate medical intervention. Typical treatments include medications to dissolve clots, procedures to open blocked arteries, and lifestyle changes.

  2. Angina: This is chest pain caused by reduced blood flow to the heart. It can be a precursor to a heart attack and requires medical evaluation. Treatment often involves medications, lifestyle changes, and sometimes surgical procedures.

  3. Anxiety or Panic Attack: While less likely given your symptoms, anxiety can cause chest pain, shortness of breath, and tingling sensations. However, given the severity and combination of your symptoms, it's crucial to rule out cardiac causes first.

  4. Infection or Inflammatory Condition: An elevated white blood cell count can indicate an infection or inflammation in the body. This could be related to a respiratory infection or another inflammatory condition that needs evaluation.

What you can do

  1. Seek Immediate Medical Attention: Given the potential for a heart attack or other serious cardiac condition, it's crucial to seek emergency medical care immediately. Call 911 or have someone drive you to the nearest emergency room. Do not attempt to drive yourself.

  2. Stop Smoking: Smoking is a significant risk factor for heart disease. Consider seeking help to quit smoking, as this can greatly reduce your risk of heart-related issues.

  3. Follow Up on Elevated WBC Count: Once the immediate concerns are addressed, follow up with your healthcare provider about your elevated white blood cell count to determine if further investigation or treatment is needed.

  4. Monitor Symptoms: Keep track of any changes or worsening of symptoms, and report these to your healthcare provider.

Remember, this information is not a substitute for professional medical advice. Please seek care from a healthcare professional to receive a formal diagnosis and appropriate treatment.

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18 d ago

People Also Ask

What are the symptoms of a heart attack in women?

Symptoms of a heart attack in women can include chest pain or discomfort, pain in the jaw, neck, or back, shortness of breath, nausea, lightheadedness, and fatigue. These symptoms can be different from the classic chest pain often associated with heart attacks in men.

How does smoking affect heart health?

Smoking damages the lining of your arteries, leading to a build-up of fatty material (atherosclerosis) which narrows the artery. This can cause angina, heart attacks, or strokes. Smoking also raises blood pressure, reduces oxygen in the blood, and makes the heart work harder.

What could cause an elevated white blood cell count?

An elevated white blood cell count can indicate an infection, inflammation, stress, or more serious conditions like blood disorders. It is important to follow up with a healthcare provider to determine the underlying cause.

What are the potential side effects of using a Nexplanon implant?

The Nexplanon implant can cause side effects such as changes in menstrual bleeding patterns, headaches, weight gain, acne, and mood changes. It's important to discuss any concerns with a healthcare provider.

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