[53M] Experiencing continuous dull chest pain

Patient Description

A 53-year-old male reports a continuous, dull pain on the upper right side of the chest, persisting for approximately 15 hours, with a severity rating of 4 out of 10. The pain does not change with position and is not tender to touch. The patient experienced a brief episode of shortness of breath 8 hours prior, which has since resolved. The patient has a history of HIV, diagnosed 20 years ago, and is currently on Efavirenz, Lamivudine, Zidovudine, and has taken Ibuprofen. There was a recent sharp pain in the foot heel, but no other new symptoms or recent injuries. The patient does not have any known drug allergies.

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Arora's Assessment

What might be happening

Based on the information you've provided, possible causes for your chest pain could include:

  • Costochondritis: This is inflammation of the cartilage that connects a rib to the breastbone (sternum). It causes chest pain that can be triggered by coughing or taking a deep breath. Even though you mentioned that your pain doesn't change with position, this condition could still be a possibility.

    • Treatment typically involves pain relievers such as ibuprofen, which you've already taken, and possibly physical therapy.
  • Musculoskeletal pain: This is pain that affects the muscles, ligaments and tendons, and bones. The pain can be localized in one area, or widespread. It could be related to your previous injury, even if it was a year ago.

    • Treatment typically involves rest and pain relief medication. Physical therapy may also be recommended.
  • Gastroesophageal reflux disease (GERD): This is a chronic condition where stomach acid frequently flows back into the tube connecting your mouth and stomach (esophagus). This backwash (acid reflux) can irritate the lining of your esophagus and cause chest pain.

    • Treatment typically involves lifestyle changes and over-the-counter medication. If these don't help, your doctor might recommend prescription medication or surgery.
  • Anxiety: Sometimes, high stress levels or panic attacks can cause chest pain. You mentioned feeling nervous and having a slightly elevated heart rate, which could be related.

    • Treatment typically involves psychological therapy, medication, and lifestyle changes.

Please note that chest pain can also be a sign of serious heart conditions, such as a heart attack. However, your symptoms are not typical of a heart attack, which is usually characterized by pain in the center of the chest that may radiate to the left arm or jaw, shortness of breath, and sweating.

What you can do

It's important that you seek medical attention to get a proper diagnosis and appropriate treatment. In the meantime, continue to monitor your symptoms and take note of anything that makes the pain better or worse.

What you should look out for

Seek immediate medical attention if your chest pain:

  • Becomes severe
  • Spreads to your back, left arm or jaw
  • Comes on suddenly and is not relieved by rest
  • Is accompanied by shortness of breath, dizziness, sweating, nausea or fainting

Remember, I'm an AI and this advice is based on the information you've given me. It's always important to consult with a healthcare professional for an accurate diagnosis.

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11 mo ago

People Also Ask


What are the common causes of chest pain in individuals with a history of HIV?

In individuals with a history of HIV, chest pain can be caused by a variety of factors including musculoskeletal issues, infections, or side effects of medications. It's important to consult a healthcare provider to determine the exact cause.


How can I differentiate between musculoskeletal chest pain and more serious conditions like a heart attack?

Musculoskeletal chest pain is often localized and may worsen with movement or palpation, whereas a heart attack typically involves severe, crushing pain that may radiate to the arm or jaw, and is often accompanied by other symptoms like shortness of breath and sweating. Immediate medical evaluation is crucial if a heart attack is suspected.


What lifestyle changes can help manage symptoms of GERD?

Lifestyle changes to manage GERD include avoiding foods and drinks that trigger reflux (such as spicy foods, alcohol, and caffeine), eating smaller meals, not lying down immediately after eating, and maintaining a healthy weight. Over-the-counter medications may also help.


Can anxiety cause physical symptoms like chest pain, and how can it be managed?

Yes, anxiety can cause physical symptoms such as chest pain. Management includes psychological therapy, stress-reduction techniques, regular exercise, and sometimes medication. It's important to address both the physical and psychological aspects of anxiety.


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