[41F] Experiencing chest pressure and gastrointestinal discomfort postprandial

Patient Description

A 41-year-old female presents with a constellation of symptoms including brain fog, fatigue, body pains, upset stomach, and pressure in the chest after eating. The brain fog has been present for approximately a year following a second bout of COVID-19 and tends to worsen in the afternoons. Body pains described as achy and dull, particularly in the leg muscles, have been occurring for a few weeks, with a severity rated at 7 out of 10. The patient experiences pressure in the chest, rated at 8 out of 10, that feels like squeezing from behind, particularly after eating. This has been occurring on and off over the past year. The patient also experiences nausea postprandially lasting from 15 minutes to half an hour. She has a history of chronic migraines since age 14, for which she takes sumatriptan and Zofran. Additionally, she takes a daily vitamin, B12 supplement, Zyrtec for allergies, and uses Flonase. The patient has a family history of both gastrointestinal and cardiac conditions, including strokes, heart attacks, bowel issues, ulcers, gallstones, and liver cirrhosis. She has had her gallbladder removed and a partial hysterectomy due to abnormal cells and ovarian cysts. She reports allergies to sulfur medications and prochlorperazine.

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Arora's Assessment

What might be happening

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

  • Post-Acute Sequelae of SARS-CoV-2 infection (PASC), also known as Long COVID: This condition refers to a range of physical and mental health problems that can linger for weeks or even months after the acute phase of a COVID-19 infection has resolved. Your symptoms of brain fog, fatigue, and body pains may be related to this condition, especially since you mentioned that they started after your second bout with COVID-19.

    • There's no specific treatment for Long COVID yet, but management usually involves treating the individual symptoms.
  • Gastroesophageal Reflux Disease (GERD): This is a chronic 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, causing symptoms like chest pressure and upset stomach after eating.

    • Treatment usually involves lifestyle changes and over-the-counter medications. In severe cases, prescription medications or surgery may be required.
  • Functional Dyspepsia: This is a chronic disorder of sensation and movement (peristalsis) in the upper digestive tract. It can cause symptoms like an upset stomach and chest pressure after eating.

    • Treatment usually involves dietary changes and medications to control the symptoms.
  • Chronic Migraines: You mentioned that you were diagnosed with chronic migraines at 14 years old. Migraines can sometimes cause symptoms like brain fog and fatigue.

    • Treatment usually involves medications to prevent or relieve migraines and lifestyle changes to avoid triggers.

What you can do

  1. Consult a healthcare provider: Given the range and severity of your symptoms, it's important to seek medical advice. They can help determine the cause of your symptoms and suggest appropriate treatments.

  2. Lifestyle modifications: Try to identify and avoid potential triggers for your symptoms. This could include certain foods, stress, lack of sleep, etc.

  3. Stay hydrated and maintain a balanced diet: This can help manage some of your symptoms and improve your overall health.

  4. Regular exercise: Physical activity can help reduce symptoms of fatigue and improve cognitive function.

  5. Mindfulness and relaxation techniques: These can help manage stress and potentially reduce symptoms of brain fog and body pains.

What you should look out for

Seek immediate medical attention if you experience:

  • Severe chest pain or pressure
  • Difficulty breathing
  • Sudden, severe headache
  • Fainting or loss of consciousness
  • Sudden, severe abdominal pain

Please remember that while I strive to provide accurate information, I'm an AI and not a substitute for professional medical advice. Always consult with a healthcare provider for a formal diagnosis and treatment.

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10 mo ago

People Also Ask


What is Long COVID and how can it affect someone after recovering from COVID-19?

Long COVID, or Post-Acute Sequelae of SARS-CoV-2 infection (PASC), refers to a range of symptoms that persist for weeks or months after the acute phase of COVID-19. Common symptoms include fatigue, brain fog, body pains, and respiratory issues. Management typically involves treating individual symptoms and supportive care.


What are the common symptoms of Gastroesophageal Reflux Disease (GERD) and how is it treated?

GERD is a chronic condition where stomach acid frequently flows back into the esophagus, causing symptoms like heartburn, chest pressure, and upset stomach. Treatment often includes lifestyle changes such as diet modification, avoiding triggers, and medications like antacids or proton pump inhibitors.


How can chronic migraines contribute to symptoms like brain fog and fatigue?

Chronic migraines can lead to symptoms like brain fog and fatigue due to the neurological impact of migraines, which can affect cognitive function and energy levels. Managing migraines often involves medications to prevent or relieve attacks and lifestyle changes to avoid known triggers.


What lifestyle changes can help manage symptoms of functional dyspepsia?

Lifestyle changes to manage functional dyspepsia include eating smaller, more frequent meals, avoiding spicy and fatty foods, reducing stress, and avoiding lying down immediately after eating. Medications may also be prescribed to help control symptoms.


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