Patient: Hello, my name is Kylie. I’m an 18 year old female who is a little concerned about some chest pain. About two weeks ago, I got a sharp pain on the left side of my chest around my heart, after moving the slightest bit. The pain is still occurring now anytime I move. The pain almost feels like a pulling or tearing sensation accompanied by tightness. Deep breaths don’t affect the pain. Only subtle movements do. The pain is sometimes so much that I want to cry. I’ve never had heart problems and I don’t recall doing anything recently that could’ve caused strain or injury to my chest. Any ideas?
Doctor: Hi.Thanks for your query.Noted your history of being 18 years old.And have sharp chest pain on the left side nea r the heart.Pain started 15 days ago and is instigated even on any movement but does not increase on deep breathing.The pain almost feels like a pulling or tearing sensation accompanied by tightness.Wants to cry due to the severity of the pain. There is no history of any strain or injury to the chest and there is no heart pain.My thoughts:Since you are young, the cardiac problem is ruled out.If your would have lung and pleura problems the breathing would have increased the pain.Your description of the pain is such hat I can think of costochondritis as the first diagnosis.Ther is inflammation of the costochondral junction of the ribs and fit the description you have given.I would suggest you the following:-Rest to the area by means of strapping with the Adhesive tapes during the deep Expiration phase. This will limit the movement, reduce the pain and give rest for healing to occur.-Anti-inflammatory medicines in full dose as per the weight.-Steroids if required for its strong anti-inflammatory role.-Lasix to reduced the edema.This sort of a treatment helps all my patients. and should help you too.