Differential Diagnosis for Chest Pain, Bloating, and Anxiety
Single Most Likely Diagnosis
- Gastroesophageal Reflux Disease (GERD): This condition is characterized by stomach acid flowing back into the esophagus, causing chest pain and bloating. Anxiety can exacerbate GERD symptoms, creating a vicious cycle.
Other Likely Diagnoses
- Irritable Bowel Syndrome (IBS): IBS can cause bloating, abdominal pain, and changes in bowel movements, which may radiate to the chest. Anxiety is a common comorbidity with IBS.
- Anxiety Disorder: Anxiety can manifest as chest pain, and the physical symptoms of anxiety (such as rapid breathing and heart rate) can worsen bloating and chest discomfort.
- Functional Dyspepsia: This condition involves recurring upper abdominal pain or discomfort, which may be accompanied by bloating and anxiety.
Do Not Miss Diagnoses
- Myocardial Infarction (MI): Although less likely given the combination of symptoms, it's crucial to rule out MI, especially if the patient has risk factors such as hypertension, diabetes, or a family history of heart disease.
- Pulmonary Embolism (PE): A life-threatening condition where a blood clot blocks an artery in the lung, PE can cause sudden chest pain and anxiety.
- Esophageal Rupture or Perforation: A rare but potentially fatal condition where the esophagus tears, requiring immediate medical attention.
Rare Diagnoses
- Esophageal Spasm: A condition where the muscles in the esophagus contract abnormally, causing chest pain and difficulty swallowing.
- Gallbladder Disease: Gallstones or inflammation of the gallbladder can cause referred pain to the chest, bloating, and anxiety.
- Panic Disorder with Cardiac Symptoms: A condition where panic attacks manifest with cardiac symptoms such as chest pain, palpitations, and shortness of breath.