Multiple Symptoms: When to Seek Medical Advice - Pulmonology

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Discomfort in multiple areas of the body?


Hello doctor, I have been experiencing a dull pain in the middle of my chest, slightly to the left, for the past week.
It feels like pressure but doesn't last long.
Sometimes, there is discomfort in the lower left part of my chest, and I press on it with my hand to distract myself.
A year ago, I saw a cardiologist who mentioned that I have mild mitral valve prolapse, but it is not severe.

Additionally, for the past three days, I have had a sensation of something stuck in my throat, as if there is an obstruction.
I have also been experiencing a tingling sensation in my tongue and a burning feeling in my mouth for the past two months.
Two months ago, an ENT specialist suggested it might be chronic pharyngitis, but the medication did not improve my symptoms.

Moreover, in the last three days, I have been experiencing unexplained skin prickling and itching.
Below my cheekbones, I feel numbness and tingling, and my speech has become slightly slurred.
My mouth movements feel a bit sluggish, but they do not interfere with my daily life.
I also notice a similar numbness in my neck and upper back, where pinching does not elicit much sensation.

Due to the multitude of symptoms, I am unsure which specialist to consult.
I am concerned that I might have diabetes, cardiovascular issues, heart problems, or neurological disorders, so I would like to seek your advice.
Thank you.

Niming, 30~39 year old female. Ask Date: 2021/11/08

Dr. Lu Mingzhi reply Pulmonology


Hello: It is recommended that you visit a family medicine physician for an initial assessment and examination.
Once a preliminary diagnosis is made, you can be referred to the appropriate specialty.
If you prefer to seek specialty care directly, based on the symptoms you described, you may first consult with a neurologist and a cardiologist to see if there are any related conditions in those fields.
If there are no findings from those specialties, you can then return to family medicine for a comprehensive evaluation.

Reply Date: 2021/11/08

More Info


Based on the symptoms you've described, it is essential to approach your situation with careful consideration and a structured plan for seeking medical advice. Your symptoms are diverse and could potentially indicate multiple underlying issues, which makes it crucial to consult with healthcare professionals who can provide a comprehensive evaluation.


Understanding Your Symptoms
1. Chest Pain: The chest pain you are experiencing, especially if it is localized to the left side, can be concerning. Given your history of mitral valve prolapse, it is important to monitor this symptom closely. While mitral valve prolapse is often benign, any new or worsening chest pain should prompt further evaluation to rule out any cardiac issues.

2. Throat Discomfort: The sensation of a foreign body in your throat, along with the burning sensation in your mouth, could be related to chronic pharyngitis or other conditions such as gastroesophageal reflux disease (GERD). If medications prescribed for chronic pharyngitis have not alleviated your symptoms, a follow-up with an ENT specialist may be warranted.

3. Skin Sensations: The unexplained skin prickling and itching can be attributed to a variety of causes, including allergic reactions, neuropathy, or even anxiety. It is important to discuss these symptoms with a healthcare provider to determine the underlying cause.

4. Facial and Body Numbness: The numbness and tingling sensations in your face, particularly around the cheeks and jaw, along with the feeling of heaviness in your neck and back, could suggest neurological issues. These symptoms warrant a thorough neurological examination to rule out conditions such as multiple sclerosis, peripheral neuropathy, or other nerve-related disorders.


When to Seek Medical Advice
Given the complexity and variety of your symptoms, it is advisable to seek medical attention promptly. Here are some guidelines on when to seek help:
- Immediate Attention: If you experience severe chest pain, shortness of breath, or any symptoms that feel life-threatening, you should seek emergency medical care immediately.

- Follow-Up Appointments: Since you have multiple ongoing symptoms, it may be beneficial to schedule an appointment with a primary care physician first. They can perform an initial assessment and refer you to specialists as needed (e.g., cardiologist, neurologist, ENT).

- Symptom Tracking: Keep a detailed log of your symptoms, including their frequency, duration, and any triggers you notice. This information can be invaluable for your healthcare provider in diagnosing your condition.


Potential Tests and Evaluations
Your healthcare provider may recommend several tests based on your symptoms, including:
- Electrocardiogram (ECG): To assess your heart's electrical activity and rule out any cardiac issues.

- Echocardiogram: To evaluate the structure and function of your heart, especially given your history of mitral valve prolapse.

- Blood Tests: To check for diabetes, thyroid function, and other metabolic conditions.

- Neurological Evaluation: This may include imaging studies such as an MRI or CT scan if neurological issues are suspected.


Conclusion
In summary, your symptoms are multifaceted and could stem from various underlying conditions. It is crucial to seek medical advice to ensure a thorough evaluation and appropriate management. Start with a primary care physician who can guide you through the process and refer you to specialists as necessary. Remember, timely intervention can make a significant difference in managing your health effectively.

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