Chest pain upper right side
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Understanding Upper Right-Side Chest Pain: Key Insights from Recent Research
Pleuritic Chest Pain and Differential Diagnosis
Pleuritic chest pain is a common cause of upper right-side chest pain. A case study involving a 33-year-old man highlighted that pleuritic chest pain can originate near the right shoulder blade and radiate throughout the right chest, worsening with deep inspiration and lying down. This type of pain can be associated with mild swelling in the lower legs and is often not accompanied by symptoms like cough, fever, or shortness of breath.
Fitz-Hugh-Curtis Syndrome: An Uncommon Cause
Fitz-Hugh-Curtis syndrome is another potential cause of right-side chest pain, though it is typically associated with severe right upper quadrant abdominal pain. This syndrome involves inflammation of the perihepatic capsules linked to pelvic inflammatory disease. Interestingly, a reported case showed that Fitz-Hugh-Curtis syndrome could present primarily as right-side chest pain without the usual pelvic inflammatory symptoms, suggesting that it should be considered in the differential diagnosis, especially in young women.
Mediastinal Mass and Chest Pain
A mediastinal mass can also present with right-side chest pain. In a case involving a 52-year-old woman, the patient experienced severe pain over the right upper abdomen and nonpleuritic, right-sided lower chest-wall pain. This pain was progressive and associated with a pressure-like sensation in the central chest. Despite the absence of respiratory symptoms, imaging revealed an elevated right-sided hemidiaphragm, indicating the presence of a mediastinal mass.
Esophageal Microperforation and Empyema Thoracis
Esophageal microperforation by a foreign object, such as a fish bone, can lead to persistent right-sided chest pain. A 64-year-old male patient presented with pain exacerbated by breathing, coughing, sneezing, or talking. Imaging revealed multiple opacified lesions in the right lung field and an encapsulated right-sided pleural effusion with bubble formation, indicating empyema thoracis. This case underscores the importance of considering esophageal perforation in patients with unexplained right-sided chest pain.
Conclusion
Upper right-side chest pain can stem from various conditions, including pleuritic chest pain, Fitz-Hugh-Curtis syndrome, mediastinal masses, and esophageal microperforation. Accurate diagnosis often requires careful consideration of the patient's history, symptoms, and imaging results. Understanding these potential causes can aid in timely and effective treatment, preventing complications and improving patient outcomes.
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