Differential Diagnosis for Right Subclavian Pain with Dyspnea
- Single Most Likely Diagnosis
- Pulmonary Embolism: This condition is a leading cause of sudden onset dyspnea and can cause referred pain to the right subclavian area due to the involvement of the pulmonary arteries. The pain and dyspnea can be exacerbated by deep breathing or movement.
- Other Likely Diagnoses
- Pneumonia: Inflammation of the lung tissue can cause pain that radiates to the subclavian area, especially if the upper lobe is involved. Dyspnea is a common symptom due to the decreased lung function.
- Pleurisy: Inflammation of the pleura can cause sharp pain that worsens with breathing, which can be referred to the subclavian area. Dyspnea can occur due to the pain limiting deep breathing.
- Costochondritis: Inflammation of the cartilage connecting the ribs to the sternum can cause chest pain that may radiate to the subclavian area. While not typically causing dyspnea directly, severe pain can lead to shallow breathing.
- Do Not Miss Diagnoses
- Aortic Dissection: Although less common, a tear in the aorta's inner layer can cause severe, tearing pain that can radiate to the back or subclavian area. Dyspnea can occur if the dissection involves the aortic arch or affects blood flow to the lungs.
- Pulmonary Hypertension: Elevated blood pressure in the pulmonary arteries can cause dyspnea and chest pain, including pain in the subclavian area, due to right ventricular strain.
- Cardiac Tamponade: Fluid accumulation in the pericardial sac can compress the heart, leading to dyspnea and chest pain, which can be referred to the subclavian area.
- Rare Diagnoses
- Pancoast Tumor: A rare type of lung cancer located at the top of the lung can cause shoulder and subclavian pain due to invasion of the brachial plexus and dyspnea due to lung involvement.
- Thoracic Outlet Syndrome: Compression of the nerves and/or blood vessels between the clavicle and first rib can cause pain in the subclavian area and dyspnea if the compression affects breathing or leads to anxiety.
- Subclavian Artery Aneurysm: An abnormal dilation of the subclavian artery can cause pain in the subclavian area and dyspnea if it compresses adjacent structures or leads to thromboembolism.