Chest pain on right side
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Causes of Right-Sided Chest Pain: A Comprehensive Overview
Pneumothorax and Exercise-Induced Chest Pain
Right-sided chest pain can be a symptom of pneumothorax, particularly in individuals who engage in vigorous exercise. A case study of a 34-year-old woman revealed recurrent episodes of sharp, pleuritic right-sided chest pain associated with dyspnea, which were linked to small apical right-sided pneumothorax. These episodes coincided with vigorous exercise and the onset of her menstrual cycle, suggesting a potential link between physical exertion and hormonal changes.
Esophageal Microperforation and Empyema Thoracis
Another potential cause of right-sided chest pain is esophageal microperforation, which can lead to empyema thoracis. A 64-year-old male presented with persistent right-sided chest pain exacerbated by breathing, coughing, and sneezing. Imaging revealed multiple opacified lesions in the right lung field and an encapsulated right-sided pleural effusion with bubble formation, indicating the presence of a high-density material in the esophagus.
Hydropneumothorax and Progressive Dyspnea
Hydropneumothorax, characterized by the presence of both air and fluid in the pleural cavity, can also manifest as right-sided chest pain. A 45-year-old woman experienced progressive dyspnea and right-sided chest pain over six months. Imaging showed a right-sided hydropneumothorax, and intercostal drainage provided symptom relief, although lung expansion was not achieved.
Pleuritic Chest Pain and Differential Diagnoses
Pleuritic chest pain, which worsens with deep inspiration and lying down, can have various underlying causes. A 33-year-old man presented with right-sided chest pain radiating from his shoulder blade, accompanied by mild swelling of the lower legs. Despite the absence of common symptoms like cough or fever, the pain's pleuritic nature suggested a complex underlying condition .
Menstrual Cycle-Related Chest Pain
Chest pain related to the menstrual cycle can also occur. A 33-year-old woman reported right-sided chest pain that worsened around her menstrual periods and when lying on her right side. Physical examination revealed diminished breath sounds and increased fremitus on the right side, indicating a potential link between hormonal changes and chest pain.
Fitz-Hugh-Curtis Syndrome
Fitz-Hugh-Curtis syndrome, an inflammation of the perihepatic capsules associated with pelvic inflammatory disease, can present atypically as right-sided chest pain. A case study highlighted a patient with severe right upper quadrant abdominal pain extending to the chest, underscoring the importance of considering this syndrome in young women with unexplained right-sided chest pain.
Chest Pain with Respiratory Infections
Respiratory infections can also cause right-sided chest pain. A man in his 60s experienced gradually worsening right-sided chest pain at rest, following a week of coryzal illness. The pain was associated with tenderness at the costochondral margins, indicating a possible link between respiratory infections and chest pain.
Postpartum Cardiovascular Issues
Postpartum women may experience right-sided chest pain due to cardiovascular issues. A 28-year-old postpartum woman presented with atypical chest pain, and further investigations revealed a critical lesion in the proximal left anterior descending artery, highlighting the need for thorough cardiovascular evaluation in postpartum women with chest pain .
Conclusion
Right-sided chest pain can arise from various conditions, including pneumothorax, esophageal microperforation, hydropneumothorax, pleuritic pain, menstrual cycle-related changes, Fitz-Hugh-Curtis syndrome, respiratory infections, and postpartum cardiovascular issues. Accurate diagnosis and appropriate management are crucial for effective treatment and prevention of complications.
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