22-Year-Old Male With Acute Chest Pain: Costochondritis Mimicking a Cardiac Event

Dr. Kishan Mishra., MBBS
 

Medical Case Details:

A 22-year-old male college student presented to the emergency department with sudden onset sharp left-sided chest pain that started while studying at his desk. The pain was severe, worsened on deep breathing and leaning forward, and radiated to the left shoulder. The patient was extremely anxious and feared that he was having a heart attack.

He had no history of smoking, hypertension, diabetes, drug use, recent trauma, or family history of cardiac disease. On examination, blood pressure was 118/76 mmHg, pulse rate was mildly elevated at 102 bpm, oxygen saturation was 98% on room air, and respiratory rate was 18/min. Chest auscultation was normal with equal air entry bilaterally. Tenderness was noted over the left 3rd and 4th costochondral junctions on palpation.

ECG showed a normal sinus rhythm without ST changes, and troponin I was negative. Chest X-ray revealed clear lung fields with no cardiomegaly or pneumothorax. CBC and CRP showed mild inflammatory changes with CRP of 18 mg/L.

The patient was diagnosed with costochondritis, likely related to prolonged poor posture during exam preparation. He was managed with reassurance, ibuprofen 400 mg three times daily for five days, warm compresses, and posture correction advice. The patient recovered completely within six days.

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A 22-year-old male college student presented to the emergency department with sudden onset sharp left-sided chest pain that started while studying at his desk. The pain was severe, worsened on deep breathing and leaning forward, and radiated to the left shoulder. The patient was extremely anxious and feared that he was having a heart attack.

He had no history of smoking, hypertension, diabetes, drug use, recent trauma, or family history of cardiac disease. On examination, blood pressure was 118/76 mmHg, pulse rate was mildly elevated at 102 bpm, oxygen saturation was 98% on room air, and respiratory rate was 18/min. Chest auscultation was normal with equal air entry bilaterally. Tenderness was noted over the left 3rd and 4th costochondral junctions on palpation.

ECG showed a normal sinus rhythm without ST changes, and troponin I was negative. Chest X-ray revealed clear lung fields with no cardiomegaly or pneumothorax. CBC and CRP showed mild inflammatory changes with CRP of 18 mg/L.

The patient was diagnosed with costochondritis, likely related to prolonged poor posture during exam preparation. He was managed with reassurance, ibuprofen 400 mg three times daily for five days, warm compresses, and posture correction advice. The patient recovered completely within six days.Gastroenterology

 

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