Question

A nurse is completing a symptom analysis with a patient complaining of chest pain. When asked what makes the chest pain worse, the patient reports that coughing and sneezing increase the chest pain. Based on these data, what does the nurse suspect as the cause of this patient's chest pain?

a. Stable angina
b. Esophageal reflux disease
c. Mitral valve prolapse
d. Costochondritis

Answer 1

The nurse would likely suspect costochondritis as the cause of the patient's chest pain since coughing and sneezing, which involve movement and stress on chest structures, are making it worse. This symptom presentation aligns more closely with costochondritis than with stable angina, esophageal reflux disease, or mitral valve prolapse.

Step-by-step explanation:

When a nurse is completing a symptom analysis with a patient complaining of chest pain and the patient reports that coughing and sneezing increase the chest pain, costochondritis is a likely suspect. Costochondritis is the inflammation of the cartilage that connects the ribs to the breastbone, and this condition can cause pain that is exacerbated by movements such as coughing and sneezing. While stable angina, esophageal reflux disease, and mitral valve prolapse can also present with chest pain, the specifics of the chest pain being worsened by coughing and sneezing point more closely to costochondritis.

Stable angina typically presents with chest pain related to physical exertion or stress and is relieved by rest or medication such as nitroglycerin. Esophageal reflux disease (GERD) might cause chest pain after eating or when lying down, and mitral valve prolapse could present with chest pain alongside palpitations and sometimes, shortness of breath. However, the act of coughing and sneezing aggravating the chest pain suggests a musculoskeletal origin, which is consistent with costochondritis, rather than a cardiac or esophageal cause.