[27M] Experiencing severe chest pain with hard lump and swelling

Patient Description

A 27-year-old male has been experiencing severe chest pain described as pressure and sharp, rated 9 out of 10 in intensity, for 3 days. The pain is exacerbated by walking and lifting but is alleviated by heat. Additionally, the patient reports a hard lump between the ribs and hard, swollen pectoral muscles, which have been present for 2 days. The lump and swelling are uncomfortable but not associated with redness, warmth, or fever. The patient uses tobacco and cannabis and has been taking Ibuprofen 200 mg every 4-5 hours for the chest pain. There is a family history of cancer or autoimmune diseases, but the patient has no known allergies, no adverse reactions to medications, and no personal history of chronic illnesses or recent injuries.

Arora's Assessment

What might be happening

Based on the information you've provided, possible diagnoses include:

Costochondritis: This is an inflammation of the cartilage that connects a rib to the breastbone (sternum). It causes chest pain that can be reproduced by pushing on the chest wall. People often mistake this pain for a heart attack. You mentioned that your pain gets worse with physical activity and improves with heat, which is consistent with costochondritis.
- Treatment typically involves pain relievers such as ibuprofen, which you are already taking, and physical therapy.
Musculoskeletal Strain: This is a strain or injury to the muscles, tendons, and ligaments in the chest. This can cause pain and swelling, and would be consistent with the hard lump you're describing.
- Treatment typically involves rest, ice, compression, and elevation (RICE), as well as pain relievers.
Tietze Syndrome: This is a rare, inflammatory disorder characterized by chest pain and swelling of the cartilage of one or more of the upper ribs. The pain can be severe, and the swelling can be hard to the touch.
- Treatment typically involves pain relievers and physical therapy.

What you can do

You should seek immediate medical attention given your severe chest pain. While the conditions listed above are not typically life-threatening, chest pain can also be a sign of more serious conditions like heart disease. It's important to get this symptom checked out as soon as possible, especially since you have a family history of cancer and autoimmune diseases.

What you should look out for

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

Chest pain that spreads to your jaw, left arm, or back
Shortness of breath, especially at rest
Dizziness, fainting, sweating, or nausea
Rapid or irregular heartbeat

Remember, I'm an AI and this advice is based on the information you've given me. It's always important to consult with a healthcare professional who can evaluate your symptoms in person.

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11 mo ago

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