Differential Diagnosis for 16-year-old Female with Chest Pain
- Single most likely diagnosis
- Pulmonary Embolism (PE): Although the patient has not used drugs in the past 3 months, her history of drug abuse increases her risk for PE. The sharp chest pain, shortness of breath, and vomiting are consistent with this diagnosis. The lack of cough or fever does not rule out PE.
- Other Likely diagnoses
- Pneumothorax: The sharp chest pain and shortness of breath could be indicative of a pneumothorax, especially given the patient's history of drug abuse, which may increase her risk for lung damage.
- Costochondritis: The anterior chest pain could be due to costochondritis, which is an inflammation of the cartilage that connects the ribs to the sternum. This condition is common in adolescents and can cause sharp chest pain.
- Gastroesophageal Reflux Disease (GERD): The patient's vomiting and sharp chest pain could be related to GERD, especially if she has been experiencing stress or eating spicy foods.
- Do Not Miss (ddxs that may not be likely, but would be deadly if missed.)
- Myocardial Infarction (MI): Although the patient is young and has no significant family history of heart disease, MI is a possibility, especially given her history of drug abuse, which can increase the risk of cardiovascular disease.
- Aortic Dissection: This is a rare but life-threatening condition that can cause severe chest pain and shortness of breath. The patient's history of drug abuse increases her risk for cardiovascular disease, which can increase the risk of aortic dissection.
- Pulmonary Hypertension: This condition can cause chest pain, shortness of breath, and vomiting, and is more common in individuals with a history of drug abuse.
- Rare diagnoses
- Spontaneous Hemopneumothorax: This is a rare condition that can cause sharp chest pain and shortness of breath, and is more common in young women.
- Catamenial Pneumothorax: This is a rare condition that occurs in women, where air enters the pleural space during menstruation, causing sharp chest pain and shortness of breath.