[43F] With chronic chest pain and multiple systemic symptoms

Patient Description

Martha Comer, a 43-year-old female, has been experiencing chest pain for almost a year. The pain varies between dull and sharp and occurs on both sides of the chest, with episodes lasting approximately 30 minutes. The severity of the pain is rated as 8 out of 10. The pain is exacerbated by arguing with her partner and walking, and sometimes relieved by a steam bath. Additional symptoms include shortness of breath, joint pain and stiffness, erectile dysfunction, itchiness, a cloudy feeling in the head, persistent tiredness with difficulty sleeping, swelling in the legs or ankles, dizziness or fainting, possible palpitations, recent weight gain, and bloating. Martha has a history of high blood pressure and was diagnosed with pleurisy about seven years ago. She has been using methamphetamine recently. She takes Ibuprofen 800mg, 3 to 4 times a day, 3 days a week, and Maca root as a supplement. There are no known drug allergies, and she is unsure about her family history of chronic conditions.

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Arora's Assessment

What might be happening

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

Chest Pain, Shortness of Breath, and Dizziness

  • Cardiovascular Issues: Given your history of high blood pressure and the severity of your chest pain, it's important to rule out cardiovascular issues such as angina, heart attack, or heart failure. These conditions can cause chest pain, shortness of breath, dizziness, and swelling in the legs or ankles.
  • Pleurisy: Since you were diagnosed with pleurisy in the past, it's possible that inflammation of the lining around your lungs could be contributing to your chest pain and shortness of breath.

Joint Pain and Stiffness

  • Arthritis: Joint pain and stiffness could be due to arthritis, which is common and can cause significant discomfort and mobility issues.
  • Methamphetamine Use: Chronic use of methamphetamine can lead to various health issues, including joint pain and cardiovascular problems.

Erectile Dysfunction and Fatigue

  • Hormonal Imbalances: Erectile dysfunction and fatigue can be symptoms of hormonal imbalances, such as low testosterone levels.
  • Diabetes: You mentioned a concern about diabetes, which can cause erectile dysfunction, fatigue, and other symptoms like increased thirst and frequent urination.

Itchiness and Cloudy Head

  • Allergic Reactions or Skin Conditions: Itchiness could be due to an allergic reaction or a skin condition like eczema.
  • Cognitive Issues: The cloudy feeling in your head could be related to stress, sleep deprivation, or even side effects of methamphetamine use.

Weight Gain and Bloating

  • Fluid Retention: Weight gain and bloating could be due to fluid retention, which can be a sign of heart failure or kidney issues.
  • Digestive Issues: Bloating can also be related to digestive issues such as irritable bowel syndrome (IBS) or food intolerances.

What you can do

Chest Pain, Shortness of Breath, and Dizziness

  • Seek Immediate Medical Attention: Given the severity and duration of your chest pain, shortness of breath, and dizziness, it's crucial to see a doctor as soon as possible. These symptoms could indicate a serious cardiovascular issue that needs prompt evaluation and treatment.
  • Monitor Symptoms: Keep track of your symptoms, including when they occur, their severity, and any triggers. This information can be helpful for your healthcare provider.

Joint Pain and Stiffness

  • Consult a Doctor: See a healthcare provider to evaluate your joint pain and stiffness. They may recommend imaging studies or blood tests to determine the cause.
  • Home Remedies: Apply ice or heat to the affected joints, take over-the-counter pain relievers like Ibuprofen (as you are already doing), and engage in gentle exercises to maintain joint mobility.

Erectile Dysfunction and Fatigue

  • Medical Evaluation: Consult a healthcare provider to evaluate for potential hormonal imbalances or diabetes. They may recommend blood tests to check your hormone levels and blood sugar.
  • Lifestyle Changes: Maintain a healthy diet, exercise regularly, and avoid substances like methamphetamine that can negatively impact your health.

Itchiness and Cloudy Head

  • Skin Care: Use gentle, fragrance-free skin care products to reduce itchiness. If the itchiness persists, consult a dermatologist.
  • Mental Health: Consider speaking with a mental health professional to address the cloudy feeling in your head and any underlying stress or anxiety.

Weight Gain and Bloating

  • Diet and Exercise: Maintain a balanced diet and engage in regular physical activity to help manage your weight and reduce bloating.
  • Medical Evaluation: See a healthcare provider to evaluate for potential causes of fluid retention and bloating, such as heart or kidney issues.

What you should look out for

Given the severity of your symptoms and the potential for serious underlying conditions, you should seek medical care as soon as possible. Reasons to seek care even more urgently include:

  • Severe or worsening chest pain
  • Fainting or severe dizziness
  • Shortness of breath that worsens or does not improve
  • Swelling in your legs or ankles that gets worse
  • Unexplained weight gain or significant bloating

Remember, while I can provide information and suggestions, it's essential to consult with a healthcare professional for a formal diagnosis and appropriate treatment. You can also use MDandMe to journal your symptoms, track progress, get insights, and share longitudinal medical notes with your provider.

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5 mo ago


People Also Ask


What could be causing my chest pain and shortness of breath?

Chest pain and shortness of breath can be caused by cardiovascular issues such as angina or heart failure, or by pleurisy, which is inflammation of the lining around the lungs. It's important to seek medical attention to rule out serious conditions.


How can methamphetamine use affect my health?

Methamphetamine use can lead to various health issues, including cardiovascular problems, joint pain, and cognitive issues. It can also exacerbate existing conditions and contribute to symptoms like fatigue and erectile dysfunction.


What are the possible reasons for my joint pain and stiffness?

Joint pain and stiffness could be due to arthritis, which is common and can cause discomfort and mobility issues. Methamphetamine use can also contribute to joint pain. Consulting a healthcare provider for evaluation is recommended.


Why am I experiencing weight gain and bloating?

Weight gain and bloating could be due to fluid retention, which may indicate heart or kidney issues, or digestive problems like irritable bowel syndrome. A medical evaluation can help determine the underlying cause.

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