[50F] Experiencing severe chest pain, dry cough, and extreme fatigue

Patient Description

A 50-year-old female presents with severe, sharp, stabbing right-sided chest pain that worsens upon coughing and has persisted since Friday night. The pain is severe enough to disrupt sleep and is rated 9 or 10 out of 10 in intensity. The patient also reports a moderate dry cough that exacerbates the chest pain and has been causing significant fatigue, to the point of being unable to perform daily tasks. There is no fever, but the patient experiences chills. The patient reports a sensation of fluid in the lungs, yet the cough remains dry. The patient has a history of pneumonia, with the last episode occurring around Christmas 2017, and has been diagnosed with COVID-19 twice before. No current medications are being taken, but the patient regularly uses natural homeopathic remedies and supplements including magnesium, iron, potassium, vitamin D3, oil of oregano, and garlic pills. The patient has an allergy to aspirin and has experienced adverse reactions to several narcotic pain medications, including Percocet, Vicodin, tramadol, and darvocet.

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Arora's Assessment

What might be happening

Based on the symptoms you've described, there are several possible conditions that could be causing your symptoms:

  • Pneumonia: Given your history of pneumonia and the symptoms you're experiencing (chest pain, dry cough, fatigue, and weakness), this could be a possibility. Pneumonia often causes chest pain that worsens when you cough or breathe in, fatigue, weakness, and a cough that may become productive over time.

    • Treatment typically involves antibiotics, rest, and hydration. In severe cases, hospitalization may be required.
  • Pleurisy: This is inflammation of the lining of the lungs and chest (the pleura) that leads to chest pain (usually sharp and stabbing) that is worse during breathing or coughing.

    • Treatment usually involves addressing the underlying cause, such as a viral infection. Over-the-counter anti-inflammatory drugs can help relieve the pain.
  • Pulmonary embolism: This is a blockage in one of the pulmonary arteries in your lungs, often due to a blood clot that travels to your lungs from your legs. Given your symptoms of sharp, stabbing chest pain, shortness of breath, and cough, this could be a possibility. However, you didn't mention any recent prolonged immobility or other risk factors.

    • Treatment typically involves anticoagulants (blood thinners) to prevent the clot from getting bigger and to stop new clots from forming.

Please note that these are possibilities based on the symptoms you've described, and it's important to get a proper diagnosis from a healthcare professional.

What you can do

Given the severity of your symptoms, it's important to seek medical attention immediately. Here are some steps you can take:

  1. If you have a healthcare provider, contact them right away and describe your symptoms. They may want to see you or direct you to an urgent care or emergency department.
  2. If your symptoms become severe, such as if your chest pain or shortness of breath worsens, call 911 or go to the nearest emergency department.
  3. Continue to rest and stay hydrated. Avoid exerting yourself physically.

What you should look out for

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

  • Your chest pain or shortness of breath worsens.
  • You start coughing up blood.
  • You experience sudden dizziness, confusion, or loss of consciousness.
  • Your symptoms don't improve, or they get worse.

Remember, it's important to consult with a healthcare professional who can evaluate your symptoms and condition. This advice is intended to support, not replace, a consultation with a healthcare provider.

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9 mo ago


People Also Ask


What are the common symptoms of pleurisy and how is it treated?

Pleurisy typically presents with sharp, stabbing chest pain that worsens with breathing or coughing. Treatment involves addressing the underlying cause, such as a viral infection, and using over-the-counter anti-inflammatory drugs to relieve pain.


How can I differentiate between pneumonia and a pulmonary embolism based on symptoms?

Pneumonia often includes symptoms like chest pain, fatigue, and a cough that may become productive, while a pulmonary embolism may present with sharp chest pain, shortness of breath, and a dry cough. A healthcare professional can provide a proper diagnosis through tests like a chest X-ray or CT scan.


What are the risks of using homeopathic remedies and supplements for respiratory conditions?

While some people find relief using homeopathic remedies and supplements, they may not be effective for serious conditions like pneumonia or pleurisy. It's important to consult with a healthcare provider to ensure these remedies do not interfere with conventional treatments.


What should I do if I have a history of adverse reactions to pain medications and need pain relief?

If you have a history of adverse reactions to pain medications, it's crucial to discuss alternative pain management options with your healthcare provider. They may recommend non-narcotic pain relievers or other therapies that are safe for you.

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