[29F] Experiencing upper back and chest pain with breathing difficulties

Patient Description

A 29-year-old female presents with a 3-day history of dull, achy chest pain that feels similar to post-severe cough discomfort, exacerbated by coughing and physical activity. The pain is generalized across the chest and in the upper right shoulder blade, described as sharp at times and achy. She also reports a 2-day history of lower leg bone discomfort, rated 4/10 in severity. Additionally, she has been experiencing mild difficulty in breathing for 2 weeks, which worsens with movement. The patient has a history of diabetes diagnosed at age 25 and asthma diagnosed at age 7. She is currently not on any medications and has no known drug allergies. Accompanying symptoms include a lack of appetite, headaches, nausea, and recent episodes of fever and chills. No recent injuries, swelling, color changes in the legs, or hemoptysis were reported.

Arora's Assessment

What might be happening

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

Pneumonia: This is an infection that inflames the air sacs in one or both lungs. The air sacs may fill with fluid or pus, causing cough with phlegm or pus, fever, chills, and difficulty breathing. Your symptoms of chest pain, trouble breathing, fatigue, and fever could be indicative of this condition.
- Treatment typically involves antibiotics, fever reducers, and cough medicine.
Pleurisy: This is an inflammation of the lining of the lungs and chest (the pleura) that leads to chest pain when you take a breath or cough. Your symptoms of chest pain and trouble breathing could be indicative of this condition.
- Treatment typically involves addressing the underlying cause and may include anti-inflammatory drugs or pain relievers.
Costochondritis: This is an inflammation of the cartilage in the rib cage. The condition usually affects the cartilage where the upper ribs attach to the breastbone (sternum), an area known as the costosternal joint. Your symptoms of chest pain could be indicative of this condition.
- Treatment typically involves pain relievers.
Asthma exacerbation: Given your history of asthma, it's possible that your symptoms of chest pain and trouble breathing are due to an asthma flare-up.
- Treatment typically involves inhaled corticosteroids and bronchodilators.
Musculoskeletal pain: This could explain your upper back pain and leg discomfort. This type of pain can be due to overuse or injury to the muscles, ligaments, and tendons.
- Treatment typically involves rest, ice, compression, and elevation (RICE), as well as pain relievers.

Please note that these are potential explanations for your symptoms, but only a healthcare professional can provide a definitive diagnosis.

What you can do

Rest and hydrate: Make sure you're getting plenty of sleep and drinking enough fluids. This can help your body recover and can also alleviate some of your symptoms.
Over-the-counter medication: Over-the-counter pain relievers can help with your chest and back pain, as well as your leg discomfort. Over-the-counter cough suppressants can also help with your cough.
Monitor your symptoms: Keep track of your symptoms and any changes. This can be helpful information for your doctor.
Seek medical attention: Given your symptoms and medical history, it's important that you seek medical attention as soon as possible. Your doctor can provide a definitive diagnosis and appropriate treatment.

What you should look out for

Seek immediate medical attention if:

Your symptoms worsen or don't improve after a few days
You have difficulty breathing or your breathing becomes more labored
You develop a high fever
You cough up blood

Please note that this advice is intended to be general in nature, and specific causes may need different management. Always consult with a healthcare provider for appropriate examination, testing, and care recommendations.

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11 mo ago

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