[43F] Experiencing chest pain and joint pain with shakiness and lightheadedness

Patient Description

A 43-year-old female reports a 4-day history of dull chest pain localized to the sternum, exacerbated by touch but not affected by breathing or coughing. She also experiences aching joint pain in her fingers, particularly in the mornings, which has been occurring on and off for 2 months. Additionally, she notes slight twitching in her hands and occasional difficulty breathing or shortness of breath. The patient mentions palpitations and that these symptoms began after taking antibiotics (Doxycycline and Flagyl). She is currently on hormone replacement therapy with Progynova (2mg, three times a day) and Endometrin (200mg, three times a day) and supplements with Omega 3 and D3 pills. There is no known family history of autoimmune diseases, no known drug allergies, and no other pre-existing conditions or chronic illnesses reported.

Arora's Assessment

What might be happening

Based on the information provided, possible diagnoses include:

Costochondritis: This is inflammation of the cartilage that connects a rib to the sternum. It might explain the chest pain you're experiencing, especially since the pain worsens when you touch the area.
- Treatment typically involves over-the-counter pain relievers such as ibuprofen or naproxen. Rest and heat applied to the area may also help.
Rheumatoid Arthritis: This is an autoimmune disorder that primarily affects the joints. It could explain the joint pain you're experiencing, particularly in your fingers and especially in the morning.
- Treatment typically involves medications to reduce inflammation in the joints and relieve pain, as well as physical therapy and sometimes surgery.
Drug-induced tremor: This is a tremor that is caused by taking certain drugs, which could potentially include the antibiotics you mentioned.
- Treatment typically involves reducing or stopping the medication causing the tremor, under the supervision of a healthcare provider.
Hormonal changes: The estrogen and progesterone you're taking could potentially be causing some of your symptoms, such as the shakiness and lightheadedness.
- Treatment would involve discussing these symptoms with the healthcare provider who prescribed these hormones, to see if a dosage adjustment or change in medication might be beneficial.

What you can do

For the chest pain, try taking over-the-counter pain relievers such as ibuprofen or naproxen, and apply a warm compress to the area. Rest and avoid strenuous activity until you can see a healthcare provider.
For the joint pain, try over-the-counter pain relievers and apply a warm compress to the affected joints. Gentle movement and stretching may also help.
For the shakiness, try to reduce stress and get plenty of sleep. Avoid caffeine and alcohol, which can make tremors worse.
Keep a symptom diary, noting when each symptom occurs, its severity, and any potential triggers. This will be helpful information for your healthcare provider.

What you should look out for

Please seek immediate medical attention if you experience any of the following:

Severe chest pain or chest pain that spreads to your jaw, left arm, or back
Sudden numbness or weakness in your face, arm, or leg, especially on one side of your body
Sudden confusion, trouble speaking, or difficulty understanding speech
Sudden trouble seeing in one or both eyes
Sudden trouble walking, dizziness, loss of balance, or lack of coordination
Severe headache with no known cause

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 appropriate examination, testing, and care.

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1 yr ago

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