What would be the reason a patient has a feeling best described as a twitching or convulsing feeling in the area just outside of the right rib just below the heart? This patient also has various undiagnosed health conditions. What test would you order and what diagnosis could be possible? Patient information is below.

The patient is a 5ft tall 17 year old female, weighing about 130 lbs, she was previously overweight at the age of 13 weighing almost 200 lbs but lost weight due to anorexia and has been in and out of episodes of anorexia where she counts calories. The patent has a diagnosis of mental health issues and chronic asthma. She takes daily medications for asthma, depression, anxiety and insomnia. The patient has had some slight drug use in the past but has recovered. She also had intestinal issues as a child and has current undiagnosed stomach issues, doctors have run multiple tests but find nothing relating to her symptoms of gastric issues which include nausea, vomiting, feeling full after eating small amounts, burning sensation felt up to the throat, coughing up blood after eating, and severe pain in the abdominal area that comes and goes. She has also had non-epileptic seizures for unknown reasons. Her family medical history mainly consists of cancer, heart problems and strokes.

The feeling of twitching or convulsing in the area just outside of the right rib just below the heart in a patient with various undiagnosed health conditions may indicate several possible diagnoses. These include muscular disorders, gastrointestinal conditions, cardiac problems, and neurological issues, among others.

The doctor may order a variety of tests to determine the underlying cause of the patient's symptoms. The patient's medical history and current symptoms will be taken into consideration in determining the appropriate diagnostic tests. Blood tests, X-rays, CT scans, MRI scans, and other diagnostic tests may be performed.

One possible diagnosis for the patient's symptoms could be a muscular disorder, such as a muscle spasm or muscle strain. These types of conditions can cause twitching or convulsing feelings in the muscles. To diagnose a muscular disorder, the doctor may order a blood test to check for muscle damage, a CT scan or MRI to look for abnormalities in the muscle tissue, or an electromyogram (EMG) to measure muscle activity.

Another possible diagnosis for the patient's symptoms could be a gastrointestinal condition, such as gastroesophageal reflux disease (GERD) or an ulcer. These types of conditions can cause pain, burning, and other symptoms in the chest and abdomen. To diagnose a gastrointestinal condition, the doctor may order an upper endoscopy or a barium swallow test to look for abnormalities in the digestive system.

A cardiac problem, such as angina or arrhythmia, could also be a possible diagnosis for the patient's symptoms. These types of conditions can cause chest pain, palpitations, and other symptoms. To diagnose a cardiac problem, the doctor may order an electrocardiogram (ECG) or a stress test to evaluate the heart's function.

Finally, the patient's symptoms could be indicative of a neurological issue, such as a seizure disorder or a nerve disorder. To diagnose a neurological problem, the doctor may order a CT scan or MRI to look for abnormalities in the brain or nervous system. Additionally, the patient may be referred to a neurologist for further evaluation.

In conclusion, the possible diagnosis for the patient's symptoms could be muscular disorders, gastrointestinal conditions, cardiac problems, or neurological issues, among others. The doctor may order a variety of tests to determine the underlying cause of the patient's symptoms based on her medical history, current symptoms, and other factors.

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