[29M] With persistent chest pain post-rehab

Patient Description

A 29-year-old male reports experiencing sharp chest pain near the heart, which has intensified over the past hour. The pain, rated 5 out of 10 in severity, worsens when lying down and is somewhat relieved by moving the arms. This discomfort has been ongoing for about 11 months, occurring daily or every other day, lasting 2-3 hours, and is more common before bedtime. The patient also experiences palpitations but denies shortness of breath or leg swelling. Notably, the pain began after donating plasma, followed by alcohol withdrawal and subsequent rehabilitation. Since achieving sobriety, the chest pain has persisted. The patient has a history of anxiety and depression, diagnosed 20 years ago, but is not currently on any medications and has no known allergies. There is no family history of heart disease, and the patient does not use tobacco, alcohol, or caffeine.

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Arora's Assessment

What might be happening

Based on your symptoms and history, here are some possibilities:

  • Musculoskeletal Pain: This could be related to muscle strain or tension, especially since moving your arms helps. Anxiety and stress can also contribute to muscle tension.

    • Treatment often involves rest, gentle stretching, and over-the-counter pain relief.
  • Anxiety-Related Chest Pain: Given your history of anxiety and recent panic attack, this could be a factor. Anxiety can cause chest pain and palpitations.

    • Treatment may include stress management techniques, therapy, or medication prescribed by a healthcare provider.
  • Costochondritis: Inflammation of the cartilage connecting a rib to the breastbone, which can cause sharp pain that worsens with certain positions.

    • Treatment typically involves anti-inflammatory medications and rest.

What you can do

  1. Relaxation Techniques: Practice deep breathing, meditation, or yoga to help manage anxiety and reduce muscle tension.
  2. Gentle Exercise: Engage in light physical activity to help relieve tension and improve overall well-being.
  3. Monitor Symptoms: Use MDandMe to journal your symptoms, track progress, and share insights with your healthcare provider.
  4. Consult a Healthcare Provider: It's important to discuss these symptoms with a doctor to rule out any serious conditions and receive appropriate treatment.

What you should look out for

Seek medical attention if you experience:

  • Severe or worsening chest pain
  • New or worsening shortness of breath
  • Dizziness or fainting
  • Any other concerning symptoms

Remember, it's important to consult with a healthcare professional for a formal diagnosis and treatment plan.

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4 mo ago

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People Also Ask


What are common causes of chest pain that worsens when lying down?

Chest pain that worsens when lying down can be caused by conditions such as musculoskeletal pain, costochondritis, or gastroesophageal reflux disease (GERD). It's important to consult a healthcare provider to determine the exact cause.


How can anxiety contribute to chest pain and palpitations?

Anxiety can lead to chest pain and palpitations due to the body's stress response, which can cause muscle tension and increased heart rate. Managing anxiety through therapy, medication, or relaxation techniques can help alleviate these symptoms.


What is costochondritis and how is it treated?

Costochondritis is the inflammation of the cartilage connecting a rib to the breastbone, causing sharp chest pain that can worsen with certain movements or positions. Treatment typically involves anti-inflammatory medications, rest, and sometimes physical therapy.


What are some effective relaxation techniques for managing anxiety-related symptoms?

Effective relaxation techniques for managing anxiety-related symptoms include deep breathing exercises, meditation, yoga, and progressive muscle relaxation. These practices can help reduce stress and muscle tension, potentially alleviating symptoms.


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