Chest Pain Differential Diagnosis
The differential diagnosis for chest pain is broad and can be categorized into several groups. Here's a breakdown of the possible causes:
Single Most Likely Diagnosis
- Acute Coronary Syndrome (ACS): This is the most common cause of chest pain in adults, especially those with risk factors such as hypertension, diabetes, and high cholesterol. The pain is typically described as a pressure or heaviness in the chest that may radiate to the arm, neck, or jaw.
Other Likely Diagnoses
- Gastroesophageal Reflux Disease (GERD): GERD can cause chest pain that is often described as a burning sensation and may be accompanied by regurgitation of food or a sour taste in the mouth.
- Musculoskeletal Pain: Musculoskeletal pain, such as costochondritis or muscle strain, can cause chest pain that is typically sharp and localized to a specific area.
- Pulmonary Embolism (PE): While not as common as ACS, PE is a significant cause of chest pain, especially in patients with risk factors such as recent surgery, immobilization, or cancer.
- Pneumonia: Pneumonia can cause chest pain that is typically sharp and worsens with deep breathing or coughing.
Do Not Miss Diagnoses
- Aortic Dissection: Aortic dissection is a life-threatening condition that requires immediate attention. The pain is typically severe and tearing in nature, and may radiate to the back.
- Pulmonary Embolism (PE): As mentioned earlier, PE is a significant cause of chest pain and can be fatal if not treated promptly.
- Cardiac Tamponade: Cardiac tamponade is a life-threatening condition where fluid accumulates in the pericardial sac, compressing the heart. The pain is typically sharp and worsens with deep breathing or movement.
Rare Diagnoses
- Esophageal Rupture: Esophageal rupture is a rare but life-threatening condition that can cause severe chest pain, often accompanied by difficulty swallowing or vomiting.
- Spontaneous Pneumothorax: Spontaneous pneumothorax is a rare condition where air accumulates in the pleural space, causing chest pain and shortness of breath.
- Pericarditis: Pericarditis is inflammation of the pericardium, which can cause chest pain that is typically sharp and worsens with deep breathing or movement.