Tenderness in the Sternum When Pressed
Greetings, I’m a 29-year-old female, standing 5 feet 5 inches tall and weighing 154 pounds. Recently, I embarked on a health journey just three days ago, as I'm not particularly active. My daily routine involves long hours sitting at a desk, which has likely contributed to my poor posture. In the past, my diet was quite unhealthy, and I frequently smoked cannabis. Additionally, I suffer from Generalized Anxiety Disorder (GAD) for which I am prescribed Zoloft. Over the last month, I have experienced unusual, sharp discomforts in my chest area on both sides, close to my heart, along with persistent upper back pain. Lately, I've noticed that my sternum is tender to the touch when I apply gentle pressure. I’m curious about what this could indicate, especially since I have a background of frequent visits to the emergency room. Unfortunately, I do not have health insurance, so I lack a primary care physician. About four months ago, I sought medical attention due to neck pain and feelings of dizziness. They conducted blood tests, an X-ray of my neck, and an ECG, all of which returned normal results. The only finding they noted was the early stages of arthritis in my neck area, which is minimal. Given the time that has passed since that visit, and given my considerable anxiety surrounding health issues, I find myself concerned about these new symptoms.
Answers (1)
3/31/2025, 1:50:35 PM
OpenHealth AI
It sounds like you're experiencing some concerning symptoms with chest tenderness and discomfort, especially with your history of anxiety about health issues. Let's address your symptoms and potential steps you can take.
Main Points:
- Chest tenderness may result from several factors including muscle strain or poor posture, but it's important to monitor and understand these symptoms further.
- Given your anxiety and the history of health concerns, recognizing patterns in your symptoms is crucial.
Explanation:
The tenderness in your sternum, particularly with your background of sedentary habits, poor posture, and anxiety, could be related to muscle strain, especially if you've recently started altering your routine. Stress and anxiety can also manifest physically, often contributing to muscle tension and discomfort in the chest. However, it’s important not to dismiss new or unusual pain, particularly near the heart area.
Your previous health evaluation that returned normal results offers some reassurance, but if new symptoms arise or if pain escalates, it might be a sign to seek further attention to rule out any other causes.
Next Steps:
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Monitor Symptoms: Keep track of when the chest tenderness occurs, its intensity, and any accompanying symptoms (like difficulty breathing, dizziness, etc.). This information could be beneficial if you need to seek care later.
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Posture and Activity: Given your long hours at a desk, consider introducing gentle stretching exercises focused on your upper back and chest to relieve tension. Maintaining good ergonomic posture while sitting can also help.
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Stress Management: Since anxiety can heighten physical symptoms, explore relaxation techniques such as deep breathing exercises, mindfulness, or gentle yoga to help alleviate anxiety and potentially lessen physical discomfort.
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Lifestyle Choices: Continuing your health journey is crucial. Focus on balanced nutrition and consider the impact of cannabis use on your anxiety levels. Reducing or eliminating its use might lead to improvements in anxiety symptoms and overall well-being.
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Know When to Seek Help: If the tenderness worsens or if you develop severe symptoms (like shortness of breath, extreme pain, or unusual sweats), prioritize seeking medical attention. In emergencies, local clinics or urgent care services might offer accessible care options even without insurance.
Your health journey is important, and taking small, manageable steps can have a positive impact on both your physical and mental well-being. If you're open to it, I can provide more detailed self-care tips or address further concerns you might have.
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# 7-Month-Old Child with Abernethy Malformation - Exploring Treatment Options ## [7-Month-Old] Identified with Abernethy Malformation (Congenital Portosystemic Shunt) - Treatment Methods? **Age:** 7 months **Gender:** Female **Height:** Age-appropriate **Weight:** Currently 9 kg, was 2.8 kg at birth **Ethnicity:** Asian **Duration of Symptoms:** Present since birth **Location:** Uzbekistan **Pre-existing Health Issues:** Abernethy malformation (congenital portosystemic shunt), liver hemangiomas, chronic jaundice, anemia **Current Treatments:** Supportive management --- ## INITIAL PRESENTATION (June 2025 - July 2025) Our daughter arrived on **June 27, 2025**, presenting with: - Birth weight: **2.8 kg** - Marked jaundice (yellowing of skin and sclera) - Pale or clay-colored stools - **Bilirubin level: 245 μmol/L** (typically <20) An immediate ultrasound indicated multiple liver anomalies, initially thought to be hemangiomas. --- ## FIRST COMPREHENSIVE ASSESSMENT (August 1, 2025 - 1 Month Old) ### Multislice Computed Tomography (MSCT) with 3-Phase Contrast (August 1, 2025): **RESULTS:** - 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7 Months Old) - **Weight:** 9 kg (good growth rate in spite of condition) - **Jaundice:** Continues to be present (yellow skin) - **Stools:** Remain pale/clay-colored - **Development:** Achieving appropriate milestones - **Energy:** Appears to have a good energy level - **Feeding:** Normal appetite --- ## QUESTIONS FOR r/AskDocs We have been informed this is **Type 2 Abernethy malformation** (portal vein present). **Three treatment avenues have been proposed:** ### Option 1: **Endovascular Coil Embolization** (minimally invasive approach) - A catheter is inserted via the leg vein to access the shunt and deploy coils/plugs to close the abnormal vessels - Pros: No surgical incision, minimal discomfort, short hospital stay (2-4 days), no scars, enhanced safety - Duration: 1-2 hours - Recovery: 2-4 weeks for jaundice to show improvement ### Option 2: **Open Surgical Intervention** - An incision in the abdomen to ligate abnormal vessels and redirect blood to the liver - Pros: Direct visualization, effective results - Cons: Surgical scar, longer recovery time (7-14 days in hospital) - Duration: 2-4 hours ### Option 3: **Liver Transplantation** - We have been advised this is not necessary as the portal vein is functional and liver health is improving. --- ## SPECIFIC QUESTIONS TO CONSIDER: 1. **With a functional portal vein (6.1 mm) and improving liver function (ALT normalized), is it advisable to pursue endovascular closure as the preferred treatment?** 2. **Despite ALT levels improving, the bilirubin remains consistently high (242). Should this be a cause for concern? Is there a prospect for it to normalize post shunt closure?** 3. **Are the hemangiomas/nodules (11.6×20.7 mm) linked to the shunt? Will they likely resolve following shunt repair?** 4. **How urgent is the proposed intervention? Is immediate action required, or is there flexibility to wait a few months?** 5. **What complications should we be vigilant for during the waiting period?** 6. **Regarding endovascular closure - what is the average success rate for infants aged 7 months? Are there concerns regarding the shunt size (9.9 mm)?** 7. **The measurement of the portal vein has shown improvement from 6.1 mm to 3.9 mm; should this be perceived as a positive sign or a reason for concern?** 8. **Are there special directives (diet modifications, medications) we should consider while awaiting the procedure?** 9. **Post-procedure, how long should we expect it might take for:** - Normalization of bilirubin levels? - Return of stool color to normal? - Resolution of jaundice? - Regression of hemangiomas? 10. **Can you recommend any specialized centers for pediatric Abernethy malformation treatments? We are located in Uzbekistan but are prepared to travel (to Turkey, Russia, South Korea, etc.)** --- ## ADDITIONAL INFORMATION - No family history of hepatic diseases - Pregnancy and delivery were normal - No additional congenital defects identified - Immunizations up to date - No history of bleeding disorders - No signs indicative of encephalopathy - Child is alert and engaged --- **I can supply actual MSCT images and comprehensive lab reports if they would be of assistance.** We sincerely appreciate any insights you can provide. We are striving to make the most informed decision regarding our daughter’s care and highly value expert medical opinions. **TL;DR:** 7-month-old diagnosed with Abernethy Type 2 malformation (9.9 mm portocaval shunt, patent portal vein). Liver functionality is improving (normalized ALT) while bilirubin remains elevated (242). Evaluating options between endovascular coil embolization and open surgery. Seeking expert advice on optimal treatment strategy and timing.