[41F] With severe upper abdominal pain and vomiting

Patient Description

A 41-year-old female reports experiencing sharp pain in the center of the upper abdominal quadrants for the past 6 weeks. The pain is severe, rated between 7-10 on a scale of 10, and is not relieved by any measures. The patient also reports chest pain described as feeling like an elephant is sitting on her, which occurs after eating but is currently rated at 0. Additionally, she experiences shortness of breath, sweating (diaphoresis), and vomiting. The last bowel movement was on Thursday, and the stool was described as brown diarrhea. The abdominal pain came on suddenly.

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Arora's Assessment

What might be happening

Based on the symptoms you've described—sharp upper abdominal pain, chest pain, shortness of breath, sweating (diaphoresis), and vomiting—there are several serious conditions that could be causing your symptoms. Here are the most likely explanations:

  1. Heart Attack (Myocardial Infarction): The combination of chest pain that feels like an elephant sitting on you, shortness of breath, and sweating is very concerning for a heart attack. This is a medical emergency and requires immediate attention.

  2. Acute Pancreatitis: Severe upper abdominal pain that radiates to the back, along with vomiting, could indicate pancreatitis. This condition can be very serious and requires prompt medical treatment.

  3. Peptic Ulcer or Gastric Perforation: Sharp abdominal pain and vomiting could be signs of a peptic ulcer or even a perforation in the stomach or intestines. This is also a medical emergency.

  4. Gallbladder Attack (Cholecystitis): Pain in the upper right quadrant of the abdomen, especially after eating, could indicate a gallbladder issue, such as cholecystitis or gallstones.

What you can do

Given the severity and combination of your symptoms, it is crucial that you seek immediate medical attention. Here are the steps you should take:

  1. Call 911 or Go to the Emergency Room: Given the potential for a heart attack or other serious conditions, you should not wait. Call 911 or have someone drive you to the nearest emergency room immediately.

  2. Do Not Drive Yourself: If you are experiencing severe pain, shortness of breath, or dizziness, do not attempt to drive yourself. It is safer to call an ambulance or have someone else take you.

  3. Stay Calm and Rest: While waiting for medical help, try to stay as calm as possible and rest. Avoid eating or drinking anything until you have been evaluated by a healthcare professional.

  4. Inform Medical Staff About Your Symptoms: When you arrive at the hospital, make sure to inform the medical staff about all your symptoms, including the duration and severity of your pain, as well as any other relevant medical history.

Remember, I am not a doctor, and this information is not a substitute for professional medical advice. Please seek care from real health professionals to receive a formal diagnosis and appropriate treatment. Your health and safety are the top priority.

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3 mo ago

People Also Ask

What are the symptoms of a heart attack in women?

Symptoms of a heart attack in women can include chest pain or discomfort, pain in the neck, jaw, or back, shortness of breath, nausea or vomiting, and sweating. Women may experience symptoms differently than men, often with more subtle signs.

How is acute pancreatitis diagnosed and treated?

Acute pancreatitis is diagnosed through a combination of blood tests to check for elevated levels of pancreatic enzymes, imaging tests like an abdominal ultrasound or CT scan, and a physical examination. Treatment typically involves hospitalization, fasting to rest the pancreas, pain management, and IV fluids.

What are the signs of a peptic ulcer or gastric perforation?

Signs of a peptic ulcer or gastric perforation include sudden, severe abdominal pain, nausea, vomiting, and sometimes a rigid abdomen. A perforation is a medical emergency and requires immediate surgical intervention.

What causes gallbladder attacks and how are they treated?

Gallbladder attacks, often caused by gallstones blocking the bile ducts, can result in severe pain in the upper right abdomen, especially after eating fatty foods. Treatment may involve dietary changes, medications to dissolve gallstones, or surgical removal of the gallbladder (cholecystectomy).

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