HomeAnswersGeneral Practitionerradiating painI have intense radiating leg pain and chest pain, which worsens while lying flat. What does it mean?

What could be causing radiating leg pain and chest pain, which worsens while lying flat?

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The following is an actual conversation between an iCliniq user and a doctor that has been reviewed and published as a Premium Q&A.

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Published At February 28, 2023
Reviewed AtJuly 19, 2023

Patient's Query

Hello doctor,

I am a 24-year-old female. I vape and have already been diagnosed with asthma, allergies, anxiety or OCD, and AVNRT. Currently, I take the tablets Luvox, Metoprolol, Loratadine, Singulair, Advair, and ProAir. Two months back, I started experiencing intense aches in my right leg and some shakiness and numbness at times. This has continued off and on since. At times, the pain spreads to my other limbs as well. I notice it is worst at night after a long day with a lot of movement or driving. I also had some issues with my bowel and bladder and stomach cramping or pain. Last month, I started experiencing intense pain or discomfort in my chest's left side, which has been pretty constant since. I cannot sleep on my left side, and if I lay that way, I start having heart palpitations. I also have to sleep at an incline. Laying flat hurts my chest and makes me feel short of breath. What has been tested: MRIs (magnetic resonance imaging) of my entire spine and brain to rule out MS or any other spinal issues. Only problem found was a dilated right carotid artery, CT scans of chest and stomach - small kidney stone and ovarian cysts found, echocardiogram - showed mild pericardial effusion and mild regurgitation, countless EKGs - all mostly normal except some PVCs, comprehensive Metabolic Panels, glucose high at times (up to 150 mg/dL), sodium consistently slightly low, carbon dioxide consistently slightly low. CBC- HCB slightly high a few times, lymphocytes slightly low a few times, MCV consistently high (in low-mid 90s), PMNs slightly high, ANA blood test - negative, A1C - normal (not diabetic or prediabetic), CRP inflammation - normal range, magnesium - normal range but on low end, vitamin B12 - normal range, rheumatoid factor - normal range, C3 complement - high (66 U/mL), vitamin D - low (15 mg/dL) and urine Test. Despite low overall protein content in the urine specimen, small quantities of low molecular weight serum proteins are noted. Albumin and tubular proteins compose the majority seen. No M proteins are observed. Pattern is consistent with increased glomerular permeability. Microalbumin - high (12.3 mg/dL), Protein - high (38 mg/dL). Please help.

Answered by Dr. Abdul Rasheed

Hello,

Welcome to icliniq.com.

I read your query and can understand your concern. From the history and investigation reports you have mentioned here, I would like to inform you that numbness and shaky feeling in your right lower limb are most likely related to magnesium insufficiency and your weight partly. As far as left-sided chest pain is concerned, it is difficult to correlate when your CT (computed tomography) scan of the chest is normal. However, pericarditis, no matter small, gives chest pain increased on inspiration. Your HBA1C is normal, but you have not mentioned the glucose levels taken in fasting or after food. If it is taken before food, 150 mg/dL is high, microalbuminuria is significant. It indicates an early sign of vascular damage, also you have vitamin D deficiency. I suggest you take effervescent magnesium tablets 400 mg daily and 60000 IU of vitamin D weekly once for at least 15 weeks for your vitamin D deficiency, along with a calcium supplement. Treatment for asthma with tablets Advair and Proair (as required) is sufficient. However, please consult a physician, discuss with them, and start taking the medications with their consent. Advice on quitting vaping and weight reduction is warranted. At BMI (basal metabolic rate) of 40 at the age of 24, you are at risk of getting serious cardiovascular and metabolic disorders. Hope this helps. Thanks and take care.

Investigations to be done

Investigation to be done are : 1. Liver function tests. 2. Lipid profile.

Regarding follow up

You should follow up with an endocrinologist.

Same symptoms don't mean you have the same problem. Consult a doctor now!

Dr. Abdul Rasheed
Dr. Abdul Rasheed

General Practitioner

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