[37F] With sudden chest pain radiating to arm and back

Patient Description

A 37-year-old female presents with sudden onset chest pain located on the left side under the left breast, accompanied by pain radiating to the left arm and upper back. The pain has persisted for approximately 5 hours and is rated as 6 out of 10 in intensity. It worsens with coughing, and there is no relief from any measures taken. The patient denies shortness of breath, nausea, dizziness, recent physical activity, injury, stress, or anxiety. There is no history of heart disease or cardiac issues, and the patient does not use tobacco or substances. Family history is negative for heart disease. The patient is currently on Lexapro 20mg and reports no other medications or supplements. There are no known allergies or adverse reactions to medications.

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Arora's Assessment

What might be happening

Based on your symptoms, there are a few possibilities to consider:

  1. Heart-Related Issues: Sudden chest pain, especially with pain radiating to the left arm and back, can be a sign of a heart attack or other cardiac issues. Even without a history of heart disease, these symptoms should be taken seriously.

  2. Musculoskeletal Pain: Pain that worsens with coughing could be related to muscle strain or inflammation, especially if you've had a persistent cough.

  3. Gastroesophageal Reflux Disease (GERD): Sometimes, acid reflux can cause chest pain that mimics heart-related pain, though it usually doesn't radiate to the arm.

It's crucial to get a proper evaluation to rule out serious conditions like a heart attack. Typical tests might include an ECG, blood tests, or imaging studies.

What you can do

  • Seek Immediate Medical Attention: Given the potential seriousness of your symptoms, it's important to see a healthcare provider as soon as possible. If the pain worsens or you feel lightheaded, call 911 or have someone take you to the emergency room.

  • Avoid Physical Exertion: Until you have been evaluated by a healthcare professional, try to rest and avoid activities that might exacerbate your symptoms.

  • Monitor Symptoms: Keep track of any changes in your symptoms, such as increased pain, shortness of breath, or new symptoms like nausea.

Remember, it's always better to be cautious with chest pain. Please seek care from a healthcare professional to get a formal diagnosis and appropriate treatment.

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2 mo ago

People Also Ask


What are the common causes of chest pain that radiates to the arm and back?

Common causes of chest pain that radiates to the arm and back include heart-related issues such as a heart attack, musculoskeletal problems like muscle strain, and sometimes conditions like gastroesophageal reflux disease (GERD). It's important to seek medical evaluation to determine the exact cause.


How can I differentiate between heart-related chest pain and other types of chest pain?

Heart-related chest pain often feels like pressure or squeezing and may be accompanied by other symptoms like shortness of breath, sweating, or nausea. Other types of chest pain, such as musculoskeletal pain, may worsen with movement or coughing. A healthcare provider can help differentiate these through tests and evaluation.


What immediate steps should I take if I experience sudden chest pain?

If you experience sudden chest pain, especially with radiating pain to the arm or back, seek immediate medical attention. Call 911 or have someone take you to the emergency room, as it could be a sign of a serious condition like a heart attack.


Can medications like Lexapro cause chest pain or related symptoms?

Lexapro, an antidepressant, is not commonly associated with causing chest pain. However, if you experience new or worsening symptoms while on any medication, it's important to discuss this with your healthcare provider to rule out any potential side effects or interactions.


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