A 36-year-old female patient presented with a recent history of chest pain around the sternum area on breathing. She suffered from flu before a week with a bit of nasal congestion and dry cough. May I know the suggestions? Thank you.
It may be pleurisy, it is due to inflammation of coverings over the lungs. Here the patient feels sharp pain when breath, and cough, sneeze also present, causes of pleuritic chest pain are bacterial or viral infections, pulmonary embolism, and pneumothorax.
It is the form of musculoskeletal pain.
Excess dry cough can lead muscular strain and so pain.
Hot compress can be applied.
If Auscultation suspicious than only further work up in form of chest x ray needed.
Diffrential diagnosis of this case is :-
muscloskeletal pain (costocondritis )
Gerd
pleurisy
chest infection
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to diffrentiate you need proper history talking and close examination .
Pericarditis should be ruled out. An ekg should be done to look for typical changes associated with it. A cardiac cause can also be additionally ruled out.
It seems to be a musculo-skeletal pain. But it is necessary to differentiate between chostocondritis and a possible pleuritis.
For this reason, it is necessary performing some tests:
- a chest X ray study
- a phenicocostal recess ultrasound for the presence of fluid
- complete blood count, PCR, sedimentation rate for inflammation.
If the pain is triggered by pressure on the chest, especially in the lower sternum, the diagnosis of chostocondritis is more probable.
Kind regards,
Dr. Aida
Pain around sternum following dry cough secondary to flu is due to costochondritis.
Symptomatic treatment like anti-inflammatory analgesic, application analgesic ointment will suffice.
It may take 2-3 weeks to subside.
Reassure the patient that it is noncardiac.
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