[66F] Experiencing chest and shoulder pain

Question

Has anyone felt like this ?

Patient Description

A 66-year-old female has been experiencing a deep, sharp chest pain located behind the left breast and pain in the left shoulder blade for about 8 or 9 days, with a severity rating of 6 to 7 out of 10. The chest pain is exacerbated when reaching or changing positions and is somewhat alleviated by sitting still, though it returns upon standing. The pain also radiates to the neck and left shoulder blade. Additionally, the patient has been experiencing a deep, dull shoulder pain, rated 5 out of 10, for approximately 5 months, which may be related to a past shoulder dislocation injury 20 years ago. The patient has a history of stage 3 kidney disease, spinal stenosis, diabetes, and high blood pressure, all managed and under control. The patient's family history includes heart disease. Current medications include Farxiga, Lisinopril, Glipizide, Famotidine, Januvia, Allopurinol, Hydrochlorothiazide, Simvastatin, Carvedilol, and Vitamin D3. There are no reported allergies or adverse reactions to medications.

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Arora's Assessment

What might be happening

Based on the information you've provided, possible explanations for your symptoms include:

  • Musculoskeletal Pain: This is pain that affects the muscles, ligaments and tendons, and bones. The pain can be caused by a variety of factors, including poor posture, repetitive movements, overuse, and wear and tear. Given your description of the pain and its location, it's possible that your symptoms are due to a musculoskeletal issue.

    • Treatment typically involves rest, physical therapy, pain relievers, and sometimes surgery.

  • Angina: This is chest pain or discomfort caused when your heart muscle doesn't get enough oxygen-rich blood. It may feel like pressure or squeezing in your chest. The discomfort also can occur in your shoulders, arms, neck, jaw, or back. Given your history of high blood pressure and diabetes, you are at a higher risk of heart disease, which can present as angina.

    • Treatment typically involves medication, lifestyle changes, and sometimes, surgery.

  • Gallbladder Disease: The gallbladder is an organ that stores bile, a fluid that helps your body break down fat from food. Gallbladder disease includes inflammation, infection, stones, or blockage of the gallbladder. Pain from gallbladder problems typically occurs in the upper right side or middle of the abdomen, but can also radiate to the right shoulder or back.

    • Treatment typically involves a change in diet and sometimes surgery.

Please note that these are possible explanations and not a definitive diagnosis. It's important to consult with a healthcare provider for an accurate diagnosis.

What you can do

  1. Schedule an appointment with your healthcare provider to discuss your symptoms. They may want to perform some tests to determine the cause of your pain.
  2. Try to rest and avoid activities that make your pain worse.
  3. Over-the-counter pain relievers may help alleviate your pain. However, it's important to consult with your healthcare provider before starting any new medication, given your current list of medications.

What you should look out for

Seek immediate medical attention if you experience:

  • Severe chest pain
  • Shortness of breath
  • Pain that spreads to the arm, neck, or jaw
  • Sweating, nausea, or vomiting accompanying chest pain
  • Dizziness, fainting, or a rapid or irregular heartbeat

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 provider for an accurate diagnosis and treatment.

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8 mo ago

People Also Ask

What are the common causes of musculoskeletal pain in the chest and shoulder area?

Musculoskeletal pain in the chest and shoulder area can be caused by poor posture, repetitive movements, overuse, or injuries such as a past dislocation. It often involves muscles, ligaments, and tendons.

How can angina be differentiated from other types of chest pain?

Angina typically presents as a pressure or squeezing sensation in the chest, often triggered by physical exertion or stress. It may radiate to the shoulders, arms, neck, jaw, or back, and is often relieved by rest or nitroglycerin.

What are the symptoms of gallbladder disease and how can it affect shoulder pain?

Gallbladder disease can cause pain in the upper right abdomen that may radiate to the right shoulder or back. Symptoms include nausea, vomiting, and pain after eating fatty foods.

What lifestyle changes can help manage high blood pressure and diabetes to reduce the risk of heart disease?

Lifestyle changes such as maintaining a healthy diet, regular exercise, quitting smoking, and managing stress can help control high blood pressure and diabetes, thereby reducing the risk of heart disease.

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1 Comments

Daisy#15667

8 mo ago

The fact that the pain is sharp and changes with position suggests its more of a musculoskeletal issue, which is less worrisome than an organ issue. I get really achy sometimes too when I stretch or bend in a weird way, my chest will tense up at once I thought I was having a heart attack or something. My doctor told me that for women especially shortness of breath plus sharp pain should be taken seriously as it can mean pulmonary embolism (blot clot in your lung).

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