[42F] Experiencing sharp pain in right side and shoulder with deep breaths

Patient Description

A 42-year-old female reports experiencing sharp pain on her right side, just below the rib cage, and in her right shoulder and neck. This pain intensifies with deep breaths and started this morning. She rates the pain as an 8 out of 10 when breathing deeply. There is no history of recent injuries to the chest or ribs, shortness of breath, cough, fever, or other chest pain. The patient has not had any recent upper respiratory infections or cold symptoms and denies any recent trauma or heavy lifting. She has a history of asthma but is not currently on any medications for it. The patient smokes cigarettes and has an allergy to penicillin. She is not currently taking any medications.

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Arora's Assessment

What might be happening

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

  • Pleurisy: This is an inflammation of the tissues that line your lungs and chest cavity. It can cause sharp pain that worsens with deep breaths. Pleurisy can be caused by infections, autoimmune conditions, or other underlying health issues.

    • Treatment: Treatment typically involves addressing the underlying cause, such as antibiotics for an infection or anti-inflammatory medications to reduce inflammation.
  • Musculoskeletal Pain: This could be due to muscle strain or inflammation in the muscles and tissues around your ribs and shoulder. This type of pain can be exacerbated by deep breathing.

    • Treatment: Rest, over-the-counter pain relievers, and applying heat or cold to the affected area can help alleviate symptoms.
  • Pulmonary Embolism: This is a more serious condition where a blood clot travels to the lungs, causing sharp chest pain that worsens with breathing. Given your history of smoking and methamphetamine use, this is a possibility that should be ruled out urgently.

    • Treatment: This condition requires immediate medical attention and is typically treated with blood thinners or other medications to dissolve the clot.
  • Pneumothorax (Collapsed Lung): This occurs when air leaks into the space between your lung and chest wall, causing sharp pain and difficulty breathing.

    • Treatment: This condition also requires immediate medical attention and may involve procedures to remove the air and allow the lung to re-expand.

What you can do

While it's important to consult a healthcare professional for a formal diagnosis and treatment, here are some steps you can take in the meantime:

  1. Rest: Try to rest and avoid activities that exacerbate the pain.
  2. Pain Relief: Over-the-counter pain relievers like ibuprofen or acetaminophen can help manage the pain.
  3. Heat or Cold Therapy: Applying a heating pad or ice pack to the affected area may provide some relief.
  4. Avoid Smoking: Smoking can exacerbate respiratory issues and delay healing. Consider reducing or quitting smoking.
  5. Monitor Symptoms: Keep track of your symptoms using the MDandMe journal. This can help you and your healthcare provider understand your condition better.

What you should look out for

Seek immediate medical attention if you experience any of the following:

  • Severe Shortness of Breath: Difficulty breathing or feeling like you can't get enough air.
  • Chest Pain: Persistent or worsening chest pain, especially if it spreads to your arm, neck, or jaw.
  • Coughing Up Blood: This could indicate a more serious underlying condition.
  • Fever or Chills: These could be signs of an infection.

Remember, while this information can help you understand your symptoms, it is not a substitute for professional medical advice. Please consult a healthcare provider for a formal diagnosis and appropriate treatment.

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3 mo ago


People Also Ask


What is pleurisy and how is it treated?

Pleurisy is an inflammation of the tissues that line the lungs and chest cavity, causing sharp pain that worsens with deep breaths. Treatment involves addressing the underlying cause, such as using antibiotics for an infection or anti-inflammatory medications to reduce inflammation.


How can musculoskeletal pain be managed at home?

Musculoskeletal pain can be managed at home by resting, taking over-the-counter pain relievers like ibuprofen or acetaminophen, and applying heat or cold to the affected area to alleviate symptoms.


What are the symptoms of a pulmonary embolism and why is it serious?

Symptoms of a pulmonary embolism include sharp chest pain that worsens with breathing, shortness of breath, and sometimes coughing up blood. It is serious because it involves a blood clot in the lungs, which can be life-threatening and requires immediate medical attention.


What should I do if I suspect I have a pneumothorax?

If you suspect you have a pneumothorax, seek immediate medical attention. This condition involves air leaking into the space between the lung and chest wall, causing sharp pain and difficulty breathing, and may require procedures to remove the air and allow the lung to re-expand.


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