[33F] Experiencing bulging and stinging veins, chest pain, and various other symptoms

Patient Description

A 33-year-old female reports bulging veins on her chest and the left side of her neck, which have been present for a few years and recently started to sting and cause pain. The affected areas also feel warm. She has been experiencing chest pain and shortness of breath during exertion for 3 years, despite ECGs and chest X-rays showing no abnormalities. The patient describes a sharp back pain near the spine, which has been present for approximately 3 years, worsening with certain movements and during sleep, rated at 9/10 for pain. Additionally, she experiences heart palpitations, described as a racing heart with occasional skipping beats and flutters, when changing positions or bending down. For a few years, she has felt tingling and numbness in her toes and a warm wet sensation on her fingers. The patient also reports head pressure, similar to the sensation of needing to pop her ears when turning her head or looking upwards, which has been occurring for 3 years. She experiences morning stiffness in her ankles and has a family history of cardiovascular issues and varicose veins. The patient has allergies to antibiotics and codeine but is not currently on any medications.

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Arora's Assessment

What might be happening

Based on the information you've provided, here are a few possibilities:

  • Varicose Veins: These are enlarged, swollen, and twisting veins, often appearing blue or dark purple. They happen when faulty valves in the veins allow blood to flow in the wrong direction or to pool. The pain you're experiencing could be due to the veins becoming inflamed and swollen.

    • Treatment often involves lifestyle changes and medical procedures to close or remove the veins.
  • Superficial Thrombophlebitis: This is inflammation of a vein just under the skin, usually in the leg, but it can also occur in the veins in the chest or neck. It can result in a red, warm, hard area on the skin, and can be painful.

    • Treatment usually involves self-care measures such as applying heat to the painful area, elevating the affected leg, and taking over-the-counter nonsteroidal anti-inflammatory drugs (NSAIDs).
  • Deep Vein Thrombosis (DVT): This is a blood clot that forms in a vein deep in the body, most often in the lower leg or thigh. It can cause pain and swelling. If a DVT travels to the lungs, it can cause a pulmonary embolism, a serious condition.

    • Treatment typically involves anticoagulant medications to prevent the clot from getting bigger and to prevent new clots from forming.

Your chest pain, shortness of breath, and heart palpitations may be related to a heart condition, given your family history of heart disease. Conditions such as angina or even heart disease itself could be possibilities.

Your back pain could be due to a variety of conditions, from muscle or ligament strain to arthritis or a herniated disc.

The tingling and numbness in your toes could be due to peripheral neuropathy, which is often a result of damage to the nerves in your peripheral nervous system, which transmit information from your brain and spinal cord to the rest of your body.

What you can do

You should seek medical attention as soon as possible. Your doctor may want to perform a physical examination and may order tests such as an ultrasound or a venogram to look at the blood flow in your veins.

In the meantime, you can try the following to alleviate your symptoms:

  1. Elevate your legs whenever possible to help reduce swelling and pain.
  2. Use over-the-counter pain relievers to help with pain and inflammation.
  3. Wear compression stockings, which can help promote blood flow and reduce swelling and pain.

What you should look out for

Please seek immediate medical attention if you experience:

  • Sudden or worsening shortness of breath
  • Chest pain that spreads to your jaw, left arm, or back
  • Sudden, severe headache with no known cause
  • Weakness or numbness on one side of your body
  • Difficulty speaking or understanding speech
  • Sudden changes in your vision

Please remember that while I strive to provide accurate information, I'm not a doctor and this advice should not replace a consultation with a healthcare professional.

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11 mo ago

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People Also Ask


What causes varicose veins and how can they be treated?

Varicose veins are caused by weakened or damaged valves in the veins, leading to blood pooling and vein enlargement. Treatment options include lifestyle changes, compression stockings, and medical procedures like sclerotherapy or laser treatment to close or remove the veins.


What is superficial thrombophlebitis and how is it managed?

Superficial thrombophlebitis is the inflammation of a vein just under the skin, often due to a blood clot. It can be managed with self-care measures such as applying heat, elevating the affected area, and taking NSAIDs to reduce pain and inflammation.


What are the symptoms and risks associated with deep vein thrombosis (DVT)?

Deep vein thrombosis (DVT) involves a blood clot in a deep vein, usually in the leg. Symptoms include pain, swelling, and redness. If untreated, it can lead to a pulmonary embolism, a life-threatening condition. Treatment typically involves anticoagulant medications to prevent clot growth and new clots.


What could be causing tingling and numbness in the toes?

Tingling and numbness in the toes could be due to peripheral neuropathy, which is often caused by nerve damage. This can result from various conditions, including diabetes, vitamin deficiencies, or nerve compression. A healthcare provider can help determine the underlying cause.


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