[34F] With chest tightness, joint pain, and elevated heart rate

Patient Description

A 34-year-old female presents with symptoms of chest tightness and pain, severe ankle pain that began suddenly today, and wrist pain near the bone in the forearm. The patient reports an elevated heart rate of 130 beats per minute. Walking or standing exacerbates the ankle pain, which is rated as a 9 out of 10 in severity. There is no swelling, bruising, or redness observed around the ankle. The patient denies any recent injuries, changes in activity level, or new footwear. Recent alcohol consumption was noted, but similar symptoms have not occurred previously after drinking. The patient is experiencing stress due to moving and has a history of anxiety and panic attacks. Medical history includes migraines since age 8, depression and anxiety since age 15, and schizoaffective disorder diagnosed 3 years ago. The patient has no known allergies or adverse reactions to medications and is not currently taking any medications.

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Arora's Assessment

What might be happening

Based on the symptoms you've described, there are a few potential explanations:

  1. Chest Tightness and High Heart Rate: These symptoms could be related to anxiety or a panic attack, especially given your history of anxiety and recent stress from moving. Anxiety can cause physical symptoms such as chest tightness, increased heart rate, and shortness of breath. However, it's important to rule out any cardiac issues, especially with a heart rate of 130 beats per minute.

  2. Wrist and Ankle Pain: The sudden onset of severe ankle pain without injury could be due to inflammation or a condition like gout, although gout is less common in women your age. Wrist pain near the bone in the forearm could be related to repetitive strain or an inflammatory condition.

  3. Unifying Diagnosis: Stress and anxiety can exacerbate physical symptoms and pain, potentially linking your chest symptoms with your joint pain. However, it's crucial to consider other causes and seek medical evaluation.

What you can do

Chest Tightness and High Heart Rate:

  • Seek Medical Attention: Given the severity of your symptoms, it's important to seek medical evaluation to rule out any serious conditions, especially related to your heart.
  • Manage Anxiety: Practice deep breathing exercises or mindfulness techniques to help manage anxiety. Consider reaching out to a mental health professional for support.

Wrist and Ankle Pain:

  • Rest and Elevate: Rest your ankle and wrist, and try to keep your ankle elevated to reduce any potential swelling.
  • Ice and Compression: Apply ice packs to the affected areas for 15-20 minutes every few hours and consider using a compression bandage for support.
  • Over-the-Counter Pain Relief: Continue with ibuprofen or another NSAID as directed, but consult a healthcare provider if pain persists or worsens.

General Health:

  • Track Symptoms: Use MDandMe to journal your symptoms, track progress, and share insights with your healthcare provider. This can help in identifying patterns and managing your conditions effectively.

What you should look out for

  • Seek Immediate Care: If you experience worsening chest pain, difficulty breathing, fainting, or any new symptoms, seek emergency medical care immediately.
  • Monitor Symptoms: Keep an eye on your heart rate and any changes in your pain levels. If symptoms persist or worsen, consult a healthcare provider.

Remember, while I can provide information and suggestions, it's important to consult with a healthcare professional for a formal diagnosis and treatment plan.

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18 d ago

People Also Ask

What could cause sudden severe ankle pain without any injury?

Sudden severe ankle pain without injury could be due to inflammation, gout, or an inflammatory condition. It's important to consider other causes and seek medical evaluation if the pain is severe or persistent.

How can anxiety affect physical symptoms like chest tightness and increased heart rate?

Anxiety can lead to physical symptoms such as chest tightness, increased heart rate, and shortness of breath. These symptoms occur due to the body's 'fight or flight' response, which can be triggered by stress or anxiety.

What are some immediate steps to take if experiencing chest tightness and a high heart rate?

If experiencing chest tightness and a high heart rate, it's crucial to seek medical attention to rule out serious conditions, especially cardiac issues. In the meantime, practicing deep breathing exercises and mindfulness can help manage anxiety.

How can one differentiate between anxiety-related symptoms and a potential cardiac issue?

Differentiating between anxiety-related symptoms and a cardiac issue can be challenging. Key indicators of a cardiac issue include chest pain that radiates to the arm or jaw, shortness of breath, and fainting. It's important to seek medical evaluation to ensure proper diagnosis and treatment.

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