[28F] With sudden onset chest pain, ear pain, and diarrhea

Patient Description

A 28-year-old female reports experiencing a sudden onset of extremely painful chest sensations since this morning, rated 7 out of 10 in severity. The pain does not cause shortness of breath but feels like an air pocket in the chest cavity and fades in and out like a slow blinking light. The patient also reports ear pain for the past 2-3 days and one episode of watery diarrhea today. Additionally, she has experienced vomiting 3-4 times today. There is a history of some heartburn or acid reflux but no fever, recent physical trauma, or exposure to sick individuals. The patient had a hysterectomy in 2022 and has a medical history significant for Gilbert's syndrome. She is allergic to Penicillin and Keflex. No recent changes in diet or exposure to environmental factors were noted.

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Arora's Assessment

What might be happening

Based on the symptoms you've described, here are some possible explanations:

Chest Pain

  • Gastroesophageal Reflux Disease (GERD): Given your history of some heartburn or acid reflux, GERD could be causing your chest pain. GERD can cause a burning sensation in the chest, which might feel like a stabbing pain.
  • Musculoskeletal Pain: Sometimes, chest pain can be due to muscle strain or inflammation, especially if it changes with movement or pressure.
  • Pleuritis: Inflammation of the tissues that line the lungs and chest cavity can cause sharp chest pain that worsens with breathing or coughing.

Ear Pain

  • Ear Infection: Given the duration of your ear pain, it could be due to an ear infection, which can cause significant discomfort.
  • Eustachian Tube Dysfunction: This can cause ear pain and is often related to allergies or upper respiratory infections.

Diarrhea

  • Gastroenteritis: This is an inflammation of the stomach and intestines, often due to a viral or bacterial infection. It can cause watery diarrhea and vomiting.
  • Dietary Causes: Sometimes, certain foods or drinks, like apple juice, can cause diarrhea, especially if consumed in large quantities.

What you can do

Chest Pain

  • GERD: Try to avoid foods and drinks that trigger your symptoms, such as spicy foods, caffeine, and alcohol. Over-the-counter antacids may help relieve your symptoms.
  • Musculoskeletal Pain: Rest and avoid activities that worsen the pain. Applying a warm compress to the area may help alleviate discomfort.
  • Pleuritis: If you suspect this, it's important to see a doctor for a proper diagnosis and treatment.

Ear Pain

  • Ear Infection: Over-the-counter pain relievers like ibuprofen can help manage the pain. Keep your ear dry and avoid inserting anything into it.
  • Eustachian Tube Dysfunction: Decongestants or antihistamines may help if allergies are the cause. Yawning, swallowing, or chewing gum can help open the Eustachian tubes.

Diarrhea

  • Hydration: Drink plenty of fluids to stay hydrated. Oral rehydration solutions can help replace lost electrolytes.
  • Diet: Stick to bland foods like bananas, rice, applesauce, and toast (the BRAT diet) until your symptoms improve.
  • Avoid Triggers: If apple juice seems to be a trigger, avoid it for now.

What you should look out for

Given the severity of your symptoms, you should seek medical care as soon as possible. Reasons to seek care even more urgently include:

  • Chest Pain: If the pain becomes severe, is accompanied by shortness of breath, dizziness, or radiates to your arm or jaw, seek emergency medical attention.
  • Ear Pain: If you develop a high fever, severe headache, or drainage from the ear, see a doctor.
  • Diarrhea: If you experience severe dehydration (dry mouth, dark urine, dizziness), blood in your stool, or if the diarrhea persists for more than a couple of days, seek medical attention.

Remember, while I can provide guidance, it's important to consult with a healthcare professional for a formal diagnosis and treatment plan. You can use MDandMe to journal your symptoms, track your progress, get insights, and share your medical notes with your provider.

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2 mo ago


People Also Ask


What could be causing my sudden chest pain if it's not related to heart issues?

Sudden chest pain can be caused by conditions like Gastroesophageal Reflux Disease (GERD), musculoskeletal pain, or pleuritis. GERD can cause a burning sensation in the chest, while musculoskeletal pain might be due to muscle strain. Pleuritis involves inflammation of the tissues lining the lungs and chest cavity.


How can I differentiate between an ear infection and Eustachian tube dysfunction?

An ear infection often presents with significant discomfort, possible fever, and sometimes drainage from the ear. Eustachian tube dysfunction, on the other hand, is often related to allergies or upper respiratory infections and may cause a feeling of fullness or popping in the ear.


What are some common causes of watery diarrhea and vomiting?

Watery diarrhea and vomiting can be caused by gastroenteritis, which is an inflammation of the stomach and intestines due to viral or bacterial infections. Dietary causes, such as consuming certain foods or drinks like apple juice in large quantities, can also lead to these symptoms.


How should I manage my symptoms if I suspect GERD is causing my chest pain?

To manage GERD-related chest pain, avoid foods and drinks that trigger symptoms, such as spicy foods, caffeine, and alcohol. Over-the-counter antacids may help relieve symptoms. It's also helpful to eat smaller meals and avoid lying down immediately after eating.


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