• Pain in the lower chest/upper abdomen
• Can be sudden in onset; may have spasmodic pain.
• Typically, it is a pleuritic-type pain exacerbated by deep breathing or movement; it can be severe enough to cause dyspnoea.
• Duration is normally a few days, but may be ≤3 weeks; it can recur/relapse.
• Fever, headache or nonspecific abdominal pain - either as prodromal symptoms or with the onset of chest pain.
• Myalgia elsewhere.
• Fever, localized tenderness at the site of the pain.
Once inside the body, the coxsackieviruses multiply in the throat and intestines then spread into the bloodstream. At this point, the body's immune defenses often can limit the infection and prevent the person from developing symptoms. If the immune defenses are less successful, the person develops a fever or other symptoms, such as headache, nausea and vomiting, and sore throat. Only a few infected people develop the classic muscle pain in the chest and upper abdomen that gives the disease its name. In these people, the coxsackievirus infection has settled in the muscles of the chest and upper abdomen, causing inflammation there.
The chest pain usually feels worse with deep breathing, called pleuritic pain. It can be a severe, stabbing pain or it can be a milder cramping in the side. Usually, only one side of the chest or abdomen is affected, although occasionally the pain can include muscles of the neck or arms.
The pain usually comes in waves that last 15 to 30 minutes, although some people report having pain episodes that last for several hours. The pain can be so severe that you have trouble breathing, sweat a lot and become anxious.
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