[41F] Experiencing chest pain, wrist pain, and transient headaches

Patient Description

A 41-year-old female reports a sharp, transient chest pain occurring every 20 minutes, unrelated to movement or eating, and sometimes relieved by burping. The pain is described as a brief, sharp stab, rated 2 out of 10 in severity. Additionally, she experiences throbbing pain and tingling in her middle fingers and the side of her left wrist, which started yesterday. She also reports a sharp, stabbing headache, described as an 'ice pick headache,' occurring randomly for the past few weeks, with each episode lasting less than a minute and rated at a severity of 5 out of 10. The patient has a history of type 2 diabetes, underactive thyroid, and PCOS, diagnosed 4 months and 23 years ago, respectively. She is currently on .75 Synthroid, 1,500 mg Metformin, and 2.5 Amlodapine. She has a family history of congestive heart failure and diabetes but no known drug allergies. No recent changes in medication or use of tobacco, recreational drugs, or alcohol have been reported.

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Arora's Assessment

What might be happening

Based on the information you've provided, here are a few possible explanations for your symptoms:

  • Gastroesophageal Reflux Disease (GERD): This is a condition where 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 heartburn, which might explain the sharp, stabbing chest pain you've been experiencing. Burping can sometimes provide relief from these symptoms.

    • Treatment typically involves lifestyle changes and over-the-counter medications. If these don't help, your doctor might recommend prescription medications or surgery.
  • Carpal Tunnel Syndrome: This is a condition caused by pressure on the median nerve as it travels through the wrist at the carpal tunnel. This might explain the pain and tingling you've been feeling in your middle fingers and the throbbing pain on the side of your left wrist.

    • Treatment typically involves wrist splinting, avoiding activities that worsen symptoms, and taking short, frequent breaks during repetitive activities using your hands.
  • Primary stabbing headache: This is a type of headache that occurs in the distribution of the first division of the trigeminal nerve. Episodes of sharp, stabbing facial pain occur without any accompanying symptoms. This might explain the sharp, stabbing headaches you've been experiencing.

    • Treatment typically involves over-the-counter pain relievers. Indomethacin, an anti-inflammatory drug, is the most commonly used treatment.

Please note that these are just possibilities and not a definitive diagnosis. It's important to consult with a healthcare provider for an accurate diagnosis.

What you can do

  1. Try to avoid foods and drinks that trigger heartburn. Everyone has specific triggers. Common triggers such as fatty or fried foods, tomato sauce, alcohol, chocolate, mint, garlic, onion, and caffeine may make heartburn worse.
  2. Try to avoid activities that can cause carpal tunnel syndrome, such as continuous typing.
  3. Over-the-counter pain relievers can provide short-term relief for a stabbing headache.

What you should look out for

Seek immediate medical attention if:

  • Your chest pain becomes severe or is accompanied by shortness of breath, pain spreading to the arms or jaw, or nausea and sweating. These could be signs of a heart attack.
  • Your wrist pain becomes severe or is accompanied by swelling, redness, or warmth. These could be signs of an infection or fracture.
  • Your headache becomes severe or is accompanied by fever, stiff neck, mental confusion, seizures, double vision, weakness, numbness, or difficulty speaking. These could be signs of a serious condition, such as a stroke or meningitis.

Remember, this advice is intended to be general in nature, and specific causes may not apply to your situation. Always consult with a healthcare provider for accurate information.

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11 mo ago

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People Also Ask


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

Common symptoms of GERD include heartburn, regurgitation of food or sour liquid, difficulty swallowing, and chest pain, especially after eating or lying down.


How can Carpal Tunnel Syndrome be managed at home?

Carpal Tunnel Syndrome can be managed at home by wearing wrist splints, avoiding repetitive hand movements, taking frequent breaks, and performing hand and wrist exercises. Over-the-counter pain relievers may also help.


What are primary stabbing headaches and how are they treated?

Primary stabbing headaches are characterized by sudden, sharp, stabbing pains in the head, often lasting only a few seconds. They are typically treated with over-the-counter pain relievers, and indomethacin is a common prescription medication used for more severe cases.


When should I seek medical attention for chest pain?

You should seek medical attention for chest pain if it becomes severe, is accompanied by shortness of breath, pain spreading to the arms or jaw, or symptoms like nausea and sweating, as these could be signs of a heart attack.


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