[32M] Experiencing severe chest pain and difficulty breathing

Patient Description

A 32-year-old male presents with severe chest pain described as needle-like pricks under the rib cage and difficulty breathing that worsens upon inhalation, both of which have been ongoing for two weeks. The patient rates the severity of both the chest pain and breathing difficulty as 10 out of 10. He has been coughing up white mucus for approximately one to two months, with a moderate cough severity. Additionally, the patient experiences wheezing and whistling sounds when breathing. The patient has been a heavy smoker for 20 years and has no known allergies or adverse reactions to medications. No pre-existing conditions, chronic illnesses, or recent injuries were reported. The patient is not currently on any medications.

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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, which may fill with fluid or pus (purulent material), causing cough with phlegm or pus, fever, chills, and difficulty breathing.

    • Treatment usually involves antibiotics, fever reducers, and cough medicine.
  • Chronic Obstructive Pulmonary Disease (COPD): This is a chronic inflammatory lung disease that causes obstructed airflow from the lungs. It's caused by long-term exposure to irritating gases or particulate matter, most often from cigarette smoke.

    • Treatment usually involves medications (like bronchodilators and steroids), pulmonary rehabilitation, and supplemental oxygen.
  • Pleurisy: This is an inflammation of the pleura, which are the two large thin layers of tissue that separate your lungs from your chest wall. It can cause sharp chest pain that worsens during breathing.

    • Treatment usually involves addressing the underlying cause and may include pain relievers and anti-inflammatory drugs.
  • Costochondritis: This is an inflammation of the junctions where the upper ribs join with the cartilage that holds them to the breastbone, causing chest pain.

    • Treatment usually involves pain relievers and rest.

What you can do

You should seek immediate medical attention. Your symptoms are severe and have been ongoing for a significant amount of time. In the meantime, try to rest and stay hydrated. Avoid smoking as it can worsen your symptoms.

What you should look out for

Seek immediate medical attention if:

  • Your symptoms worsen
  • You have difficulty speaking or become confused
  • You experience severe chest pain
  • You cough up blood

Please remember that while I strive to provide accurate information, I am an AI and cannot replace a consultation with a healthcare professional.

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10 mo ago

People Also Ask


What are the common symptoms of pneumonia?

Common symptoms of pneumonia include cough with phlegm or pus, fever, chills, and difficulty breathing. Some people may also experience chest pain, fatigue, and confusion, especially in older adults.


How does smoking contribute to Chronic Obstructive Pulmonary Disease (COPD)?

Smoking is the leading cause of COPD as it damages the airways and the small air sacs in the lungs, leading to inflammation and obstruction of airflow. Long-term exposure to cigarette smoke is a major risk factor for developing COPD.


What is pleurisy and how is it treated?

Pleurisy is an inflammation of the pleura, the tissue layers surrounding the lungs and lining the chest cavity. It causes sharp chest pain that worsens with breathing. Treatment focuses on addressing the underlying cause and may include pain relievers and anti-inflammatory medications.


What are the signs that chest pain might be due to costochondritis?

Costochondritis is characterized by sharp chest pain that is often localized to the front of the chest near the breastbone. The pain may worsen with certain movements or pressure on the chest. It is typically treated with pain relievers and rest.


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