Why does the right side of my chest hurt
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Causes of Right-Sided Chest Pain: A Comprehensive Overview
Right-sided chest pain can be a symptom of various underlying conditions, ranging from benign to life-threatening. This article synthesizes findings from multiple research papers to provide a comprehensive understanding of potential causes.
Pleuritic Chest Pain
Pleuritic Pain and Inflammation
Pleuritic chest pain, characterized by sharp pain that worsens with deep breathing or lying down, can be caused by inflammation of the pleura. A case study of a 33-year-old man highlighted pleuritic pain originating near the right shoulder blade and radiating throughout the right chest, exacerbated by deep inspiration and lying down . This type of pain is often associated with pleuritis or other inflammatory conditions affecting the pleura.
Esophageal Microperforation
Another potential cause of right-sided chest pain is esophageal microperforation. A 64-year-old male experienced persistent right-sided chest pain exacerbated by breathing, coughing, sneezing, or talking. Imaging revealed an encapsulated right-sided pleural effusion and a high-density material in the lower third of the esophagus, indicating a microperforation likely caused by a fish bone.
Thoracic and Pulmonary Conditions
Pneumothorax
Recurrent right-sided chest pain can also be indicative of a pneumothorax. A 34-year-old woman experienced sharp, pleuritic chest pain with radiation to the back and dyspnea, associated with a small apical right-sided pneumothorax, particularly during vigorous exercise and the first day of her menses.
Thymic Cyst
A giant thymic cyst can mimic pleural effusion and cause significant right-sided chest pain. A 24-year-old woman presented with a large right-sided pleural effusion, which upon further investigation was identified as a thymic cyst almost filling the right hemithorax.
Gastrointestinal and Hepatic Causes
Fitz-Hugh-Curtis Syndrome
Fitz-Hugh-Curtis syndrome, an inflammation of the perihepatic capsules associated with pelvic inflammatory disease, can present atypically with right-sided chest pain. This syndrome should be considered in the differential diagnosis, especially in young women, to prevent chronic complications.
Cardiovascular Causes
Coronary Artery Disease
Right-sided chest pain can also be a manifestation of coronary artery disease. A 28-year-old postpartum woman with atypical right-sided chest pain was found to have a critical lesion in the proximal left anterior descending artery, highlighting the importance of considering cardiac causes in the differential diagnosis.
Traumatic Injuries
Diaphragm Rupture
Traumatic injuries, such as a diaphragm rupture, can cause right-sided chest pain. A 29-year-old man involved in a motor vehicle collision presented with diffuse right-sided chest and abdominal pain, which was later diagnosed as a right-sided diaphragm rupture.
Conclusion
Right-sided chest pain can arise from a variety of conditions, including pleuritic inflammation, esophageal perforation, pneumothorax, thymic cysts, Fitz-Hugh-Curtis syndrome, coronary artery disease, and traumatic injuries. Accurate diagnosis requires careful consideration of the patient's history, symptoms, and appropriate imaging studies. Early identification and treatment are crucial to prevent complications and ensure optimal patient outcomes.
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