What causes rib cage pain and coughing up blood?

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Posted on Sat, 13 Jun 2015 in General Health
Question: Hi, My boyfriend is 48 yrs old. For the last few days he's had a bad pain on his right side, up by his rib cage. The pain gets worse when he lays down. He also has a hard time taking a deep breath. This morning he was coughing up blood. That stopped 9 hours ago. He refuses to go to the Doctor. He was a Professional Baseball player, & runs a Travel Baseball Organization, in which he gives Hitting lessons eveyday. Could you please help me figure out what the problem could be? Thank you.
doctor
Answered by Dr. Panagiotis Zografakis 15 minutes later
Brief Answer:
It needs investigation

Detailed Answer:
Hello,

although I cannot provide any certain diagnosis at this time, I can only say that this sounds serious. Having rib cage pain without an injury or fever and coughing up blood may be caused by serious (and perhaps urgent) conditions. I'll mention some:
- pulmonary embolism: this is a clot that moved from the legs to the pulmonary vessels and occluded some of them. This is an urgent situation.
- serious infections like tuberculosis
- cancer (of the lung or metastatic)
- injury

He needs at least a chest X-ray, arterial oxygen assessment, some basic blood tests and perhaps a CT-scan of the chest.

I hope I've helped!

You can contact me again, if you'd like to ask for clarifications or further information, or if you'd like to add some useful details.

Kind Regards!


Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Panagiotis Zografakis 7 minutes later
You dont think it could be a pulled muscle on the side? Or an ulcer? Or a kidney stone?
doctor
Answered by Dr. Panagiotis Zografakis 7 minutes later
Brief Answer:
Probably not

Detailed Answer:
Hello,

although a pulled muscle could have caused the pain, it has nothing to do with the blood. If he had a bleeding ulcer he wouldn't be coughing up blood. He could vomit blood though. Blood that comes out after coughing, originates from the lungs or the upper respiratory tract. Finally a kidney stone, while it could have caused significant pain on the flank (and perhaps radiating to the front and to his genitals) it can't justify the blood.

So it the symptoms are really connected (which is what happens most of the times - most people have only one illness that explains all their symptoms) to each other then the list I've presented in my previous answer is more likely.

Please take into account that clinical examination data are invaluable for making up such lists. I didn't mean to scare you with this list but I meant to emphasize the fact that there are serious diagnoses that have to be excluded. More 'benign' diagnoses are also possible.

Kind Regards!
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Answered by
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Dr. Panagiotis Zografakis

Internal Medicine Specialist

Practicing since :1999

Answered : 3675 Questions

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