[66F] Experiencing severe chest pain and shortness of breath

Patient Description

A 66-year-old female presents with sharp, stabbing left-sided chest pain that has persisted for two days. The pain is severe, with an intensity of 8/10, and worsens upon inhalation. Accompanying symptoms include shortness of breath, frequent belching, dizziness, lack of energy, and sweating. The patient has not eaten in a few days and reports a lack of appetite. She has a history of high blood pressure but has not been taking her prescribed medications, Norvasc and Atenolol, due to a recent move and lack of access to a healthcare provider. No known allergies or adverse reactions to medications have been reported.

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Arora's Assessment

What might be happening

Based on the information you've provided, possible diagnoses include:

  • Acute Coronary Syndrome (Heart Attack): This is a serious condition where the blood supply to the heart is suddenly blocked, usually by a blood clot. Symptoms can include chest pain, shortness of breath, sweating, and nausea. This is a medical emergency and requires immediate treatment.

    • Treatment typically involves medications to break up the clot and restore blood flow, and sometimes a procedure to open up the blocked artery.
  • Angina: This is a condition where the blood supply to the muscles of the heart is restricted, usually due to the arteries supplying the heart becoming hardened and narrowed. Symptoms can include chest pain, shortness of breath, and fatigue.

    • Treatment typically involves lifestyle changes, medications to reduce the risk of a heart attack, and sometimes surgery or procedures to improve blood flow.
  • Gastroesophageal Reflux Disease (GERD): This is a digestive disorder that affects the lower esophageal sphincter, the ring of muscle between the esophagus and stomach. Many people, including pregnant women, suffer from heartburn or acid indigestion caused by GERD. Overeating, obesity and certain foods can cause this.

    • Treatment typically involves lifestyle changes and over-the-counter medications. If these don't help, prescription medications or surgery might be an option.
  • Gastritis: This is an inflammation of the stomach lining. The inflammation of gastritis is most often the result of infection with the same bacterium that causes most stomach ulcers. Regular use of certain pain relievers and drinking too much alcohol can also contribute to gastritis.

    • Treatment typically involves taking antacids and other drugs to reduce stomach acid, which helps relieve gastritis symptoms.

What you can do

Given the severity of your symptoms and the potential seriousness of conditions like Acute Coronary Syndrome, it's crucial that you seek immediate medical attention. Please go to the emergency department immediately or call for an ambulance.

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 gets worse
  • You feel faint, dizzy, or lose consciousness
  • You have a sudden, severe headache
  • You have difficulty speaking or understanding speech
  • You have sudden weakness or numbness in your face, arm, or leg, especially on one side of your body
  • You have sudden trouble seeing in one or both eyes

Remember, I am an AI and this advice is based on the information you've provided. It's important to consult with a healthcare professional who can evaluate your symptoms in person.

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10 mo ago

People Also Ask


What are the symptoms of a heart attack and how do they differ from angina?

Symptoms of a heart attack can include severe chest pain, shortness of breath, sweating, nausea, and pain radiating to the arm or jaw. Angina also causes chest pain but is usually triggered by physical exertion or stress and relieved by rest. Heart attack pain is more severe and persistent.


How can high blood pressure contribute to chest pain and what are the risks of not taking prescribed medications?

High blood pressure can lead to heart disease, increasing the risk of chest pain due to reduced blood flow to the heart. Not taking prescribed medications can worsen blood pressure control, increasing the risk of heart attacks and strokes.


What lifestyle changes can help manage GERD and gastritis symptoms?

Lifestyle changes for managing GERD and gastritis include eating smaller meals, avoiding trigger foods (like spicy or fatty foods), not lying down immediately after eating, losing weight if overweight, and reducing alcohol and caffeine intake.


When should someone with chest pain seek emergency medical attention?

Immediate medical attention is necessary if chest pain is severe, persistent, or accompanied by symptoms like shortness of breath, dizziness, fainting, or pain radiating to other parts of the body. These could be signs of a heart attack or other serious conditions.


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