Question

A 25-year-old accountant presents to your clinic complaining of intermittent lower right sided chest pain for several days. He describes it as knifelike and states it only lasts for 3 to 5 seconds taking his breath away. He states he feels like he has to breathe shallowly to keep it from recurring. The only thing that makes it better is lying quietly on his right side. It is much worse when he takes a deep breath. He has taken some Tylenol and put a heating pad on his side but neither has helped. He remembers that two weeks ago he had an upper respiratory infection with severe hacking cough. He denies any recent trauma. His past medical history is unremarkable. His parents and siblings are in good health. He has recently married and his wife has a baby due in two months. He denies any smoking or illegal drug use. He drinks two or three beers a month. He states that he eats a healthy diet and runs regularly but not since his recent illness. He denies any cardiac, gastrointestinal or musculo-skeletal symptoms. On examination he is lying on his right side but appears quite comfortable. His temperature, blood pressure, pulse and respirations are unremarkable. His chest has normal breath sounds on auscultation. Percussion of the chest is unremarkable. During palpation the ribs are non-tender.
What disorder of the chest best describes his symptoms?

a. Pericarditis
b. Chest wall pain
c. Pleural pain
d. Angina pectoralis

Answer 1

Answer:

c. Pleural pain

Explanation:

Pleural pain is a sharp and burning sensation experienced in the chest during inhalation and exhalation and could be caused by a range of factors such as trauma to the chest and infections.

It was observed that the patient doesn’t smoke and his chest has normal breath sounds on auscultation. He had an infection which could be the major cause of the pain.The percussion of the chest is unremarkable which points to pleural pain.