Sharp pain in chest when inhaling
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Sharp Pain in Chest When Inhaling: Causes and Considerations
Asthma and Sharp Chest Pain
Asthma can be a significant contributor to sharp chest pain, particularly when inhaling. A case study of a 20-year-old woman with a history of asthma revealed that she experienced severe chest pain exacerbated by deep inspiration. This pain was accompanied by shortness of breath, a moderate wheeze, and a mild cough producing whitish sputum. Despite treatment with salbutamol and ipratropium nebulizers, her chest pain persisted, indicating that asthma exacerbations can lead to sharp chest pain even after initial treatment.
Pleuritic Chest Pain: Differential Diagnosis
Pleuritic chest pain is another common cause of sharp, stabbing pain in the chest during inhalation. This type of pain can be due to various serious conditions, including pulmonary embolism, which is found in 5% to 21% of patients presenting with pleuritic chest pain in emergency settings. Other critical conditions to consider include myocardial infarction, pericarditis, aortic dissection, pneumonia, and pneumothorax. These conditions should be ruled out through a combination of history, physical examination, electrocardiography, troponin assays, and chest radiography.
Viral Infections and Pleuritic Pain
Viral infections are also common causes of pleuritic chest pain. Pathogens such as Coxsackieviruses, respiratory syncytial virus, influenza, parainfluenza, mumps, adenovirus, cytomegalovirus, and Epstein-Barr virus can trigger this type of pain. Treatment typically involves managing the underlying viral infection and using nonsteroidal anti-inflammatory drugs (NSAIDs) for pain relief. For patients with persistent symptoms, smokers, and those over 50 years old with pneumonia, follow-up chest radiography is recommended to ensure resolution.
Conclusion
Sharp chest pain when inhaling can stem from various causes, including asthma exacerbations and pleuritic chest pain due to serious conditions or viral infections. Proper diagnosis and treatment are crucial, involving a thorough clinical evaluation and appropriate use of diagnostic tools to rule out life-threatening conditions. Managing the underlying cause and symptomatic relief with NSAIDs are common approaches to treatment.
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