[54F] With sudden onset of burning chest pain

Patient Description

A 54-year-old female presents with a sudden onset of burning sensation in the chest, rated 9 out of 10 in severity. The pain has not subsided since its onset. The patient denies experiencing shortness of breath, sweating, dizziness, changes in bowel movements, or difficulty swallowing. There is no recent consumption of spicy, fatty, or acidic foods. The patient does not smoke or consume alcohol. Medical history includes high blood pressure, asthma, arthritis, and anxiety, all diagnosed in 2006. Current medications include Albertol (inhaler) and Lastarn (100mg). The patient is unsure about any drug allergies and is not taking any other medications, supplements, or herbal remedies.

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Arora's Assessment

What might be happening

Based on the information you have provided, the most likely diagnosis is:

  • Gastroesophageal Reflux Disease (GERD): GERD 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 a burning sensation in your chest, known as heartburn. Given your history of acid reflux and the fact that you are already taking Pantoprazole, it is possible that your current symptoms are related to GERD.
    • Typical Treatments: GERD is often managed with lifestyle changes and medications. Since you are already on Pantoprazole, your doctor might consider adjusting the dosage or adding another medication. In some cases, further testing such as an endoscopy might be recommended to assess the severity of the condition.

What you can do

While you should consult a healthcare professional for a formal diagnosis and treatment plan, here are some steps you can take to help alleviate your symptoms:

  1. Avoid Trigger Foods: Even though you haven't recently consumed spicy, fatty, or acidic foods, it's a good idea to continue avoiding them as they can exacerbate GERD symptoms.
  2. Eat Smaller Meals: Large meals can increase stomach pressure and lead to acid reflux. Try eating smaller, more frequent meals.
  3. Stay Upright After Eating: Avoid lying down for at least two to three hours after eating to prevent acid from flowing back into your esophagus.
  4. Elevate Your Head While Sleeping: Raising the head of your bed by about 6 to 8 inches can help prevent nighttime reflux.
  5. Maintain a Healthy Weight: Excess weight can put pressure on your abdomen, pushing up your stomach and causing acid to back up into your esophagus.
  6. Use MDandMe: You can use MDandMe to journal your symptoms, track your progress, get insights, and share longitudinal medical notes with your healthcare provider.

What you should look out for

While GERD is usually not life-threatening, there are certain symptoms that warrant more urgent medical attention:

  • Severe Chest Pain: If your chest pain is severe and does not improve with antacids, it could be a sign of a more serious condition like a heart attack.
  • Difficulty Swallowing: If you start having trouble swallowing or feel like food is getting stuck in your throat, you should see a doctor.
  • Unexplained Weight Loss: Significant weight loss without trying could indicate a more serious underlying condition.
  • Persistent Vomiting: If you start vomiting frequently, especially if it contains blood or looks like coffee grounds, seek medical attention immediately.

Remember, while this advice can help manage your symptoms, it is essential to consult a healthcare professional for a formal diagnosis and appropriate treatment.

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3 mo ago


People Also Ask


What are the common symptoms of GERD?

Common symptoms of GERD include a burning sensation in the chest (heartburn), regurgitation of food or sour liquid, difficulty swallowing, and a sensation of a lump in the throat. Some people may also experience chronic cough, laryngitis, or new or worsening asthma.


How can GERD be managed or treated?

GERD can be managed with lifestyle changes such as avoiding trigger foods, eating smaller meals, and not lying down after eating. Medications like proton pump inhibitors (e.g., Pantoprazole) or H2 blockers may be prescribed to reduce stomach acid. In severe cases, surgery might be considered.


When should someone with GERD symptoms seek urgent medical attention?

Urgent medical attention should be sought if someone with GERD experiences severe chest pain that does not improve with antacids, difficulty swallowing, unexplained weight loss, or persistent vomiting, especially if it contains blood or looks like coffee grounds.


Can lifestyle changes help alleviate GERD symptoms?

Yes, lifestyle changes can significantly help alleviate GERD symptoms. These include avoiding foods and drinks that trigger reflux, eating smaller meals, staying upright after meals, elevating the head while sleeping, and maintaining a healthy weight.

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