Differential Diagnosis for Chest Pain with Inspiration
The differential diagnosis for chest pain with inspiration can be categorized into the following groups:
Single Most Likely Diagnosis
- Pleuritic Chest Pain: This is the most likely diagnosis, as the pain is triggered by inspiration, which is a classic symptom of pleuritic chest pain. Pleuritic chest pain is often caused by inflammation of the pleura, such as in pneumonia or pulmonary embolism.
Other Likely Diagnoses
- Pneumonia: Infection of the lung tissue can cause inflammation of the pleura, leading to pleuritic chest pain.
- Pulmonary Embolism: A blood clot in the lungs can cause pleuritic chest pain, especially if the clot is located near the pleura.
- Pneumothorax: Air in the pleural space can cause pleuritic chest pain, especially if the pneumothorax is large or under tension.
- Costochondritis: Inflammation of the cartilage that connects the ribs to the sternum can cause chest pain that worsens with inspiration.
Do Not Miss Diagnoses
- Myocardial Infarction: Although myocardial infarction typically presents with exertional chest pain, it can occasionally present with pleuritic chest pain, especially if the infarct involves the right ventricle.
- Aortic Dissection: A tear in the aorta can cause severe chest pain that can be pleuritic in nature, especially if the dissection involves the ascending aorta.
- Pulmonary Hypertension: Elevated pulmonary artery pressures can cause chest pain that worsens with inspiration, especially if the patient has underlying lung disease.
Rare Diagnoses
- Pulmonary Arteriovenous Malformation: A rare congenital anomaly that can cause pleuritic chest pain due to abnormal blood flow in the lungs.
- Sarcoidosis: A rare autoimmune disease that can cause inflammation of the lungs and pleura, leading to pleuritic chest pain.
- Eosinophilic Pneumonia: A rare inflammatory disease that can cause pleuritic chest pain due to eosinophilic infiltration of the lungs.