# Chest pain



## Two-Speed (Feb 18, 2010)

21yo female, sharp pain on left side of chest under her breast.
Feels pain when drinking, otherwise pain comes and goes...if anyone knows what this could be, please let me know.  Internet searches are yeilding no results.


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## medicdan (Feb 18, 2010)

This could be so many things...
It sounds like you are fishing for a diagnosis for yourself or a friend, and that isn't right. If you are truly worried about it, see your PCP (It's free, you're in Canada! eh), go to Urgent Care, etc, don't seek help on an anonymous forum on the internet.


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## Lifeguards For Life (Feb 18, 2010)

emt.dan said:


> This could be so many things...
> It sounds like you are fishing for a diagnosis for yourself or a friend, and that isn't right. If you are truly worried about it, see your PCP (It's free, you're in Canada! eh), go to Urgent Care, etc, don't seek help on an anonymous forum on the internet.



While I fully agree with Dan, to play the game, based on the single isolated complaint given by the OP, I would guess precoridal catch syndrome. 

The pain associated with precordial catch syndrome is usually on the left side, under the rib. The pain occurs just under the left nipple, near where you feel the heart beat most strongly on the front of the chest, and comes on very suddenly, and is stabbing in nature.


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## OHMEDIC (Feb 19, 2010)

To many possible things...if it's that severe...time to see the Doc.


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## Melclin (Feb 19, 2010)

Are we going to get more information? Are you presenting this as a scenario to be worked?

Pulse, BP, Monitor and temp? 

Can we get a better description of the pain: frequency, length of pain, nature/character of the pain etc. Hx of any recent poor health/infections? Hows her skin? 

And of course all the normal stuff...allergies, meds, medical problems, risk factors (smoker, diet, weight, stress, family hx etc).

It does sound a bit like precordial catch syndrome, I get that with frustrating frequency...quite uncomfortable too, but better to ask all those questions seeing as though you're there. 

If you aren't asking for educational purposes but rather for yourself or someone else..you're an idiot - go to the doctor mate  . 

(Unfortunately, I feel I have to point out to the mods, lest I get another wrist slapping, that the use of the word idiot was lighthearted and not at all a genuine attempt at an 'personal insult')


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## DrankTheKoolaid (Feb 21, 2010)

*re*

You didnt say what she was drinking but im going to have to assume your talking ETOH.   If thats the case the obvious would be a pancreatitis.  Would need work up by her PCP to rule out anything cardiac in nature


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## DrankTheKoolaid (Feb 21, 2010)

*re*

To late to edit my last post.  Let me qualify by saying he didnt specify how far her breast drop which really is a vague statement as to where her pain actually is.  But left chest / LUQ pain especially with ETOH use would lead me to an acute/chronic pancreatits as my first choice.  After ruling out anything cardiac in nature


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## Lifeguards For Life (Feb 21, 2010)

Corky said:


> You didnt say what she was drinking but im going to have to assume your talking ETOH.   If thats the case the obvious would be a pancreatitis.  Would need work up by her PCP to rule out anything cardiac in nature



There would be a whole mess of other signs and symptoms associated with pancreatitis. A person with pancreatitis usually looks and feels very ill and know that they need prompt medical attention.

A blood workup should quickly rule out pancreatitis, as the blood contains at least three times the normal amount of amylase and lipase, even in acute pancreatitis.


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## DrankTheKoolaid (Feb 21, 2010)

*re*

I beg to differ as i transport a chronic pancreatits patient almost weekly due to her poor following a ETOH restrictions and diet changes.  Her only complaint for me is LUQ/left CX wall pain.  Only once in the MANY times i have transportred her has she had any other complaint (nausea w/o vomiting).  And no she doesnt look nearly as ill as most of my patients.  And yes labs would be more definitive but since the original author was just asking for suggestions on what we suspect this to be.

I'm not a zebra hunter and im going to have to guess that there are ALOT more patients out there with pancreatitis then PCS cases as the majority of PCS cases most likely go unreported due to patient denial or lack or reporting it to a MD.  And since i cant find anything relating ETOH use to increased PCS, im sticking with pancreatitis as my first guess. But peptic ulcer among other GI issues my also be the root cause


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## VentMedic (Feb 21, 2010)

This could be anything from an esophageal spasm to GERD and everything inbetween.  

We do not not know anything about this person except for age and when the symptoms seem to appear.  We have never seen this person and have never assessed her.  We have no history, weight, height or dietary information about this person.  Thus, it is no more than a guessing game and being done by some with a very limited amount of medical education. One should also not base their "diagnosis" on a patient they saw last week who had the same pain.  Everybody and every body can respond differently or respond very similar to pain with totally different etiologies. Without additional information and an actual assessment of the patient, not second hand information, all one can give is a guess from assumptions.

If this person is concerned, she should see her PCP who can see her in person, do an assessment, take a history and do whatever diagnostic testing is necessary.


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## DrankTheKoolaid (Feb 21, 2010)

VentMedic said:


> This could be anything from an esophageal spasm to GERD and everything inbetween.
> 
> We do not not know anything about this person except for age and when the symptoms seem to appear.  We have never seen this person and have never assessed her.  We have no history, weight, height or dietary information about this person.  Thus, it is no more than a guessing game and being done by some with a very limited amount of medical education. One should also not base their "diagnosis" on a patient they saw last week who had the same pain.  Everybody and every body can respond differently or respond very similar to pain with totally different etiologies. Without additional information and an actual assessment of the patient, not second hand information, *all one can give is a guess from assumptions.*
> If this person is concerned, she should see her PCP who can see her in person, do an assessment, take a history and do whatever diagnostic testing is necessary.





Seriously? you took the time to write all the crap out.  Everyone knows it's just a guess.  This is a discussion forum and nobody here would consider calling anything we do a diagnosis when were exchanging ideas about scenerios.  Lighten up people this is a *Discussion* forum


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## VentMedic (Feb 21, 2010)

Corky said:


> Seriously? you took the time to write all the crap out. Everyone knows it's just a guess. This is a discussion forum and nobody here would consider calling anything we do a diagnosis when were exchanging ideas about scenerios. Lighten up people this is a *Discussion* forum


 
Seriously, the OP is identified as a former student. The OP did not identify the reason for the question. The OP has not returned to offer any more information if this was to be an ongoing scenario and stated he was also searching the internet for answers. 

Do you feel like you are qualified to give medical advice to the general public? Do you "diagnose" sight unseen or without any information? Do you seriously think this 21 y/o has pancreatitis without even knowing what she was drinking? 

If this is a layperson asking the question about a friend or whoever, they should be directed to their PCP.  That is the best advice to give when one does not know the intent of the OP.


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## ExpatMedic0 (Feb 21, 2010)

more info please, is the guy who started this still around?


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