Table of Contents
Common Questions
Chat with CodyMD
Cody's Chat with Patient
Cody's AI Summary
Top 3 AI Diagnosis List
Review by Dr Albert DiPiero
Dr. DiPiero Video Guide to this Case Study
Resource Center
Testimonials
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Case Study
Meet your host
Albert DiPiero, MD MPH FACP
I am a co-founder and the Chief Medical Officer at CodyMD and your host for this edition of Cody Grand Rounds. I have been a practicing physician and faculty member at medical schools for over 26 years.
About The AI Doctor Case Study
CodyMD is a partnership between Human Doctors and AI Doctors. Cody is an AI Doctor who helps thousands of people every day. At each Cody Grand Rounds, I select a real case and review it with Cody, the AI Doctor.
Each case is based on a real patient but has been modified to maintain privacy and to emphasize certain teaching points.
Common Questions
What could cause sharp chest pain with dizziness in young women?
How does smoking affect chest pain?
What are the symptoms of a pulmonary embolism?
Can anxiety cause physical symptoms like chest pain and dizziness?
Are birth control pills linked to increased risk of blood clots?
How can you differentiate between an asthma attack and other causes of chest pain?
Can an AI doctor diagnose chest pain?
What is the role of an AI symptom checker?
Chat with CodyMD
Click the button below to initiate a conversation with CodyMD, your AI Doctor.
Cody's Chat with Patient
Below is a conversation transcript between the patient and our AI Doctor CodyMd.
Cody, the AI Doctor
Hello! I’m here to help figure out what might be causing your chest pain and dizziness. Can you tell me more about what you’re experiencing?
Patient
Hi, thanks for your help. Yeah, I’ve been having this really sharp pain in my chest and feeling dizzy for about three hours now. It came out of nowhere.
Cody, the AI Doctor
That sounds quite uncomfortable. On a scale from 1 to 10, with 10 being the worst pain imaginable, how would you rate this chest pain?
Patient
It’s definitely a 10. It hurts a lot, especially when I take deep breaths.
Cody, the AI Doctor
I see, deep breaths making it worse can be a clue. Have you noticed any breathing difficulties or shortness of breath along with the chest pain?
Patient
Yes, I do feel a bit breathless, but it’s not as bad as some past asthma flares I’ve had.
Cody, the AI Doctor
Got it. Given your history of asthma, do you think the dizziness might be related, or is it something different this time?
Patient
This dizziness feels different. It’s not like the light-headedness I get sometimes with asthma. It feels more unsettling.
Cody, the AI Doctor
Have you experienced any recent cough or fever?
Patient
No, I haven’t had a cough or fever at all.
Cody, the AI Doctor
And have you been feeling more anxious since these symptoms started?
Patient
Yes, definitely. The pain and dizziness are making me really anxious. I’m worried something serious might be wrong.
Cody, the AI Doctor
Understandable. Can you tell me about any medications you're currently taking and any habits like smoking?
Patient
I take birth control pills and, well, I smoke cigarettes and vape every day, about half a pack of cigarettes usually.
Cody, the AI Doctor
Thanks for sharing. It seems smoking is quite regular for you. Is this something you might have started recently, or has this been an ongoing habit?
Patient
I’ve been smoking like this for a couple of years now.
Cody, the AI Doctor
Alright, thank you for providing all this information. Let me summarize what I’ve gathered and discuss the possibilities with you.
Cody's AI Summary
- You are a 20-year-old woman is experiencing sharp chest pain and dizziness for the past three hours
- You rate your pain as severe pain rated 10 out of 10.
- The pain intensifies with breathing, and there is mild shortness of breath.
- You have a history of anxiety and asthma.
- You take oral contraceptives
- You smoke half a pack of cigarettes daily, and use vaping products.
- You have no cough or fever is present, but do notice increased anxiety since the symptom onset.
Top 3 AI Diagnosis List
Based on the information and conversations with Cody, we have prepared a top 3 AI Diagnosis List.
1. Pulmonary Embolism( 50 % probability)
A blood clot could lodge in the lungs, leading to sharp chest pain, dizziness, and shortness of breath. Contributing factors include smoking and oral contraceptive use.
2. Asthma(30 % probability)
While the patient has asthma, symptoms are not typical of her usual flares, indicating this may not be the primary cause.
3. Anxiety Attack(20 % probability)
Anxiety could manifest with symptoms like chest pain and dizziness, especially given the patient's history.
Review by Dr Albert DiPiero
Dr. Albert DiPiero
Upon reviewing the case of this 20-year-old woman with sharp chest pain and dizziness, several points are critical. The differential diagnosis provided by Cody, the AI doctor, offers valuable insights. Here is my further analysis:
1. Pulmonary embolism(60% probability)
Given her smoking history and oral contraceptive use, this is a significant possibility. An AI doctor can effectively identify such risk factors by analyzing patient history and symptoms, offering a valuable preliminary diagnostic view. The sudden, severe chest pain and dizziness align well with this diagnosis, and this must be ruled-out first.
2. Asthma(25% probability)
Considering her well-documented asthma and current respiratory symptoms, this could present atypically as chest pain and breathlessness. However, severe dizziness and pain—more profound than her usual asthma attacks—suggest it may not be the primary cause. I adjusted the probability to 25%. The AI symptom checker's role here is critical in assessing these atypical manifestations and suggesting an appropriate course of action.
3. Anxiety Attack(15% probability)
Her history of anxiety cannot be discounted. The overlap of physical symptoms that anxiety often exacerbates raises this diagnosis to 15% probability. An AI symptom checker can help differentiate anxiety symptoms from more critical health issues by assessing symptom severity and onset patterns.
4. Contribution of Smoking and Vaping:
Smoking and vaping are known to cause a variety of respiratory issues, ranging from chronic bronchitis to acute chest pain and increased risk of thoracic complications like pulmonary embolism. Nicotine and other chemicals in cigarettes and vaping products can increase heart rate and blood pressure, potentially inducing dizziness and contributing to anxiety symptoms. These effects further complicate distinguishing between causes of symptoms, showing a significant intervention opportunity for AI-based diagnostics in flagging potential risks associated with these habits.
Next Steps for Evaluation
Immediate diagnostic tests, including a CT pulmonary angiogram or D-dimer test, are necessary to confirm or rule out pulmonary embolism. Further monitoring of vitals, ECG, and possibly an arterial blood gas (ABG) test are warranted to assess airway function and oxygenation.
Potential Treatment Modalities
If pulmonary embolism is confirmed, anticoagulants are critical. Asthma exacerbation requires management with bronchodilators. Addressing anxiety would focus on supportive care and potentially anti-anxiety medication once other causes are ruled out.
Conclusion
Given the serious nature of a possible pulmonary embolism, quick action is recommended. The patient's risk factors, especially smoking and vaping habits, coupled with her symptoms' sudden onset and severity, merit prompt and thorough evaluation. Reducing smoking and vaping habits and re-evaluating contraceptive methods may be future considerations to mitigate similar risks. AI diagnostic tools can aid significantly in initial assessments, emphasizing lifestyle factors and guiding further medical interventions.
Dr. DiPiero Video Guide to this Case Study
Resource Center
Testimonials
CodyMD is a very precise and accessible app. My consultation with CodymMD is commendable and I highly recommend it for others to try CodyMD especially for assessment and consultation purposes.
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Dr Cody spot on, better than most Human Drs. Also far more pleasant. Try him, he could better help you understand your issues. He will give you good info for your Drs visit as well.
TrustPilot Review
It gave me the best response possible and suggested simple self care treatment options which I'm in favor with. It has a to the point interface and brief answer for better understanding.
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