[42F] With intermittent sharp chest pain and breast lump history

Patient Description

A 42-year-old female reports experiencing sharp chest pain over the heart, occurring intermittently throughout the day, with each episode lasting a couple of seconds. The pain is rated as 6 out of 10 in severity. The patient also feels hot but has not identified any specific triggers or relievers for the pain. There are no associated symptoms of shortness of breath, palpitations, heartburn, or indigestion. The patient denies recent stress, physical exertion, or changes in activity related to the pain. She has a significant history of tobacco use for 27 years, currently about half a pack a day, but has reduced usage recently. A breast lump was first diagnosed in 2011. The patient is currently taking Suboxone, one pill twice daily, and has an allergy to Toradol. There is no known personal or family history of heart disease, high blood pressure, or high cholesterol.

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Arora's Assessment

What might be happening

Based on your symptoms, here are some possibilities:

  • Musculoskeletal Pain: Sharp chest pain that comes and goes could be related to muscle strain or inflammation in the chest wall. This is often not serious and can be caused by physical activity or poor posture.

    • Treatment typically involves rest, over-the-counter pain relievers, and applying heat or ice.
  • Anxiety or Stress: Sometimes, stress or anxiety can cause chest pain that feels sharp and comes and goes.

    • Techniques such as deep breathing, relaxation exercises, and stress management can help.
  • Gastroesophageal Reflux Disease (GERD): Although you haven't experienced heartburn, GERD can sometimes cause chest pain.

    • Treatment includes dietary changes, antacids, and avoiding triggers like tobacco.

Given your history of a breast lump, it's important to continue monitoring any changes and consult with a healthcare provider for regular check-ups.

What you can do

  • Lifestyle Changes: Reducing tobacco use is a positive step. Continue to cut back and consider seeking support to quit completely.
  • Symptom Tracking: Use MDandMe to journal your symptoms, track any changes, and share this information with your healthcare provider.
  • Relaxation Techniques: Practice stress-reduction techniques such as meditation or yoga to see if they help with your symptoms.

What you should look out for

Seek medical attention if you experience:

  • Severe or worsening chest pain
  • Shortness of breath, dizziness, or fainting
  • Pain spreading to your arm, neck, or jaw

Remember, it's important to consult with a healthcare professional for a formal diagnosis and treatment plan.

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4 mo ago

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People Also Ask


What are the common causes of sharp chest pain that comes and goes?

Common causes of sharp chest pain that comes and goes include musculoskeletal issues like muscle strain, anxiety or stress, and sometimes conditions like gastroesophageal reflux disease (GERD). It's important to consult a healthcare provider for an accurate diagnosis.


Can anxiety or stress cause physical symptoms like chest pain?

Yes, anxiety or stress can cause physical symptoms, including chest pain. This type of pain is often sharp and intermittent. Techniques such as deep breathing, relaxation exercises, and stress management can help alleviate these symptoms.


How does tobacco use affect chest pain or heart health?

Tobacco use can negatively impact heart health and may contribute to chest pain. It increases the risk of heart disease and can exacerbate conditions like GERD, which can also cause chest pain. Reducing or quitting tobacco use is beneficial for overall health.


What should I do if I experience severe or worsening chest pain?

If you experience severe or worsening chest pain, especially if it's accompanied by shortness of breath, dizziness, fainting, or pain spreading to your arm, neck, or jaw, seek medical attention immediately as these could be signs of a serious condition.


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