[35F] Experiencing chest and back pressure with headache

Patient Description

A 35-year-old female reports experiencing chest and back pressure, described as feeling like trapped gas, with a severity of 8 out of 10. The symptoms have persisted for several weeks and are exacerbated by lying down. Over-the-counter medication, Gas-X, was tried without significant relief. The patient also experiences nausea, difficulty swallowing, and right shoulder discomfort. The chest pressure occurs after consuming any food and persists throughout the day. The headache developed gradually, and the patient has no history of similar headaches, heart disease, or high blood pressure. There is no shortness of breath reported.

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Arora's Assessment

What might be happening

Based on the symptoms you've described—chest and back pressure, headache, nausea, armpit pain, breastbone pain, right shoulder discomfort, and difficulty swallowing—there are a few possible explanations:

  1. Gastroesophageal Reflux Disease (GERD): This condition occurs when stomach acid frequently flows back into the tube connecting your mouth and stomach (esophagus). This backwash (acid reflux) can irritate the lining of your esophagus and cause symptoms like chest pressure, nausea, and difficulty swallowing. It can also cause discomfort in the back and shoulders.

    • Treatment: Lifestyle changes such as avoiding trigger foods, eating smaller meals, and not lying down immediately after eating can help. Over-the-counter medications like antacids, H2 blockers, or proton pump inhibitors may also be recommended.
  2. Musculoskeletal Pain: The combination of chest, back, and shoulder discomfort could be related to muscle strain or tension, possibly from poor posture or stress.

    • Treatment: Rest, gentle stretching, and over-the-counter pain relievers like ibuprofen or acetaminophen can help alleviate symptoms.
  3. Anxiety or Stress: Sometimes, anxiety can manifest physically, causing symptoms like chest pressure, headaches, and nausea.

    • Treatment: Stress management techniques such as deep breathing exercises, meditation, or speaking with a mental health professional can be beneficial.
  4. Cardiac Concerns: While less likely given the absence of shortness of breath or a history of heart disease, it's important to consider that chest pressure and related symptoms could be cardiac in nature.

    • Treatment: If cardiac issues are suspected, a healthcare provider may recommend tests like an ECG or stress test to rule out heart-related causes.

What you can do

  1. Lifestyle Adjustments: Try to identify and avoid any foods or activities that seem to trigger your symptoms. Eating smaller, more frequent meals and avoiding lying down after eating may help if GERD is a concern.

  2. Symptom Tracking: Use MDandMe to journal your symptoms, track any changes, and note any potential triggers. This information can be valuable for your healthcare provider.

  3. Hydration and Diet: Ensure you stay hydrated and maintain a balanced diet. Avoid caffeine, alcohol, and spicy or fatty foods that might exacerbate symptoms.

  4. Relaxation Techniques: Practice stress-reduction techniques such as yoga, meditation, or deep breathing exercises to help manage any anxiety-related symptoms.

What you should look out for

  • Seek Medical Attention: If you experience severe chest pain, shortness of breath, or any new or worsening symptoms, seek medical attention promptly.
  • Monitor Symptoms: Keep an eye on your symptoms, especially if they persist or worsen. If your symptoms do not improve with lifestyle changes or over-the-counter treatments, consult a healthcare provider for further evaluation.

Remember, while this information can be helpful, it's important to consult with a healthcare professional for a formal diagnosis and appropriate treatment.

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5 mo ago

Top picked over-the-counter products for Acid Reflux (GERD): American College of Gastroenterology Guidelines

People Also Ask


What are the common symptoms of Gastroesophageal Reflux Disease (GERD)?

Common symptoms of GERD include heartburn, chest pain, regurgitation of food or sour liquid, difficulty swallowing, and a sensation of a lump in the throat. Some people may also experience nausea and discomfort in the back and shoulders.


How can lifestyle changes help manage GERD symptoms?

Lifestyle changes can help manage GERD symptoms by reducing the frequency and severity of acid reflux. These changes include avoiding trigger foods, eating smaller meals, not lying down immediately after eating, maintaining a healthy weight, and avoiding smoking and alcohol.


What are some non-cardiac causes of chest pressure?

Non-cardiac causes of chest pressure can include GERD, musculoskeletal pain from muscle strain or tension, anxiety or stress, and other gastrointestinal issues like gas or bloating.


When should I seek medical attention for chest pressure?

You should seek medical attention for chest pressure if it is severe, accompanied by shortness of breath, dizziness, or pain radiating to the arm or jaw, or if it is a new or worsening symptom that does not improve with lifestyle changes or over-the-counter treatments.


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