[51F] With severe nasal congestion and multiple symptoms

Patient Description

A 51-year-old female presents with severe nasal congestion that has persisted for approximately 2 weeks. The patient reports constant runny nose leading to a sore inside the left nostril, while the right nostril is completely blocked. The severity of the congestion is rated as 10 out of 10, significantly affecting sleep. Additional symptoms include headache, chest pain, wheezing, tingling fingers in the left arm, watery eyes, and ringing in the ears. The patient has noted that the symptoms were triggered by recent exposure to allergens, changes in weather, and possibly recent illness. No relief has been found with any measures tried so far.

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Arora's Assessment

What might be happening

Based on the symptoms you've described, here are some possible explanations:

Allergic Rhinitis

  • Rationale: Your symptoms of a constantly runny nose, nasal congestion, and watery eyes are classic signs of allergic rhinitis, especially since you mentioned exposure to allergens like pollen and plants in your yard.
  • Typical Treatments: Over-the-counter antihistamines (like Claritin or Zyrtec), nasal corticosteroid sprays (like Flonase), and decongestants can help. Avoiding known allergens and using air purifiers may also provide relief.

Sinusitis

  • Rationale: The sore inside your nose, severe congestion, and the duration of your symptoms (about 2 weeks) could indicate a sinus infection (sinusitis).
  • Typical Treatments: Treatment may include nasal saline rinses, decongestants, and sometimes antibiotics if a bacterial infection is suspected. A healthcare provider can confirm this diagnosis.

Respiratory Infection

  • Rationale: Wheezing, chest pain, and a runny nose could be signs of a respiratory infection, such as a cold or bronchitis.
  • Typical Treatments: Rest, fluids, and over-the-counter medications to relieve symptoms. If symptoms persist or worsen, a healthcare provider may prescribe antibiotics or other treatments.

Neurological Issues

  • Rationale: The tingling in your left arm and ringing in your ears could be related to a neurological issue or even a side effect of severe congestion affecting your sinuses and ears.
  • Typical Treatments: A healthcare provider may recommend imaging studies or refer you to a specialist for further evaluation.

What you can do

For Nasal Congestion and Runny Nose:

  • Avoid Allergens: Try to stay indoors during high pollen times and use air purifiers.
  • Medications: Use over-the-counter antihistamines, nasal corticosteroid sprays, and decongestants as directed.
  • Nasal Rinses: Saline nasal rinses can help clear out allergens and mucus.
  • Hydration: Drink plenty of fluids to help thin mucus.

For Chest Pain and Wheezing:

  • See a Doctor: Given the chest pain and wheezing, it's important to consult a healthcare provider to rule out serious conditions like asthma or infections.
  • Avoid Irritants: Stay away from smoke, strong odors, and other respiratory irritants.

For Tingling in Left Arm and Ringing in Ears:

  • Monitor Symptoms: Keep track of when these symptoms occur and their severity.
  • Consult a Doctor: These symptoms could be related to your nasal issues or something else, so it's important to get a professional evaluation.

General Tips:

  • Rest: Ensure you get plenty of rest to help your body recover.
  • Humidifier: Using a humidifier can help keep your nasal passages moist.
  • Symptom Journal: Use MDandMe to journal your symptoms, track progress, get insights, and share longitudinal medical notes with your provider.

What you should look out for

Seek medical care urgently if you experience:

  • Severe or worsening chest pain
  • Shortness of breath
  • High fever
  • Severe headache or neck stiffness
  • Sudden weakness or numbness in your limbs

Remember, while I can provide information and suggestions, it's crucial to consult with a healthcare professional for a formal diagnosis and appropriate treatment. If you have more questions or need further assistance, feel free to continue the conversation.

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5 mo ago


People Also Ask


What are the common symptoms of allergic rhinitis?

Common symptoms of allergic rhinitis include a runny or stuffy nose, sneezing, itchy eyes, and watery eyes. These symptoms are often triggered by exposure to allergens such as pollen, dust, or pet dander.


How can I differentiate between sinusitis and a common cold?

Sinusitis often involves facial pain or pressure, nasal congestion, thick nasal discharge, and a reduced sense of smell, lasting more than 10 days. A common cold typically resolves within a week and may not include facial pain or pressure.


What could cause tingling in the arm and ringing in the ears?

Tingling in the arm and ringing in the ears can be caused by various factors, including nerve compression, sinus congestion affecting the ears, or neurological issues. It's important to consult a healthcare provider for a proper evaluation.


When should I seek medical attention for chest pain and wheezing?

You should seek medical attention for chest pain and wheezing if the pain is severe, persistent, or accompanied by shortness of breath, high fever, or if it worsens over time. These could be signs of a more serious condition that requires prompt medical evaluation.


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