A 22 year female presents with a sudden onset of mid-line th
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Sheetal  Sangwan
A 22 year female presents with a sudden onset of mid-line thoracic pain 2 days back(after lunch).
The pain shoots up severely on sitting or laying or standing (i.e changing posture)and after a while come back to continous dull pain with heaviness. Pain also aggravates on deep inhalation.
no Shortness of breath
No p/h/o any allegry /trauma
not k/c/o asthma ,htn.
what should be done next to make daignosis??
G●●●l K●●●h and 4 others like this2 shares
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Dr. Y●●h B●●●●●r
Dr. Y●●h B●●●●●r Internal Medicine
Chest xray - to check mediastinal / pleural / cardiac /infectious etiology Baseline ECG ANA & antibody workup for sarcoidosis , rheumatoid arthritis , SLE etc If initial ChestXray negative -> could check for esophageal dysmotility ( 24 hr Gatric Ph monitoring , barium swallow ) for Diffuse esophageal spasm/achalasia/strictures/esophagitis If all results above negative - can give a trial of PPP ... Read more
Jun 24, 2020Like3
Dr. Y●●h B●●●●●r
Dr. Y●●h B●●●●●r Internal Medicine
Also esophageal manometry among esophageal checkup
Jun 24, 2020Like1
Dr. U●●●s B●●●●●●●r
Dr. U●●●s B●●●●●●●r Internal Medicine
Upper GI endoscopy and oesophageal manometery should be advised
Jun 24, 2020Like