[50F] Experiencing intermittent left-sided chest and upper back pain with shortness of breath

Patient Description

A 50-year-old female reports intermittent left-sided chest pain that has been occurring for several days. The pain is described as a stabbing sensation that worsens with deep breathing, sneezing, or certain movements, and is particularly severe when lying down. The pain is primarily located to the left of the sternum and sometimes radiates to the upper back next to the left shoulder blade. The severity of the chest pain is rated an 8 out of 10, and sitting upright and remaining still may provide some relief. Additionally, the patient has been experiencing shortness of breath for months, which is severe and makes it difficult to take in air, also rated an 8 out of 10 in severity. The patient has a history of Rheumatoid arthritis diagnosed 8 years ago and is currently on Cellcept. Known allergies include Penicillin and Floricine. No other medications or symptoms were reported.

Arora's Assessment

What might be happening

Based on the information you've provided, possible diagnoses include:

Costochondritis: This is an inflammation of the cartilage in your rib cage. The condition causes chest pain that can spread to your back or abdomen. It's often caused by physical strain or a respiratory infection, and it's more common in people with autoimmune diseases like rheumatoid arthritis.
- Treatment usually involves rest, physical therapy, and medication to reduce inflammation and manage pain.
Pleurisy: This is an inflammation of the tissues that line the lungs and chest cavity. The pain often worsens with movement of the upper body or deep breathing.
- Treatment usually involves addressing the underlying cause, such as an infection, and may include anti-inflammatory drugs or pain relievers.
Tracheal stenosis: This is a narrowing of the trachea that can cause symptoms like shortness of breath. You've mentioned that you've been diagnosed with this condition, and it could be contributing to your symptoms.
- Treatment typically involves procedures to widen the trachea, and may include surgery or stenting.
Heart conditions: While less likely based on your description, certain heart conditions can cause chest pain and shortness of breath. Conditions like angina or pericarditis could be possible.
- Treatment depends on the specific condition, but may involve medication, lifestyle changes, or in some cases, surgery.

What you can do

Seek immediate medical attention: Chest pain can be a sign of serious conditions, including heart problems. It's important to get this checked out as soon as possible.
Rest and avoid physical strain: If your pain is due to costochondritis or pleurisy, rest and avoiding strenuous activities may help.
Over-the-counter pain relief: Non-prescription pain relievers may help manage your pain, but always check with a healthcare professional before starting any new medication.

What you should look out for

Seek immediate medical attention if you experience:

Severe chest pain
Chest pain that spreads to your jaw, left arm, or back
Chest pain with shortness of breath, sweating, dizziness, or nausea
Rapid or irregular heartbeat

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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