Differential Diagnosis for Chest Pain
The differential diagnosis for chest pain is extensive 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, particularly 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 arms, neck, or jaw.
Other Likely Diagnoses
- Gastroesophageal Reflux Disease (GERD): Chest pain can be a symptom of GERD, especially if it's accompanied by regurgitation, dysphagia, or a sour taste in the mouth.
- Musculoskeletal Pain: Costochondritis, muscle strain, or rib fractures can cause chest pain that's often 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 deep vein thrombosis, cancer, or recent surgery.
- Pneumonia: Chest pain can be a symptom of pneumonia, especially if it's accompanied by fever, cough, or shortness of breath.
Do Not Miss Diagnoses
- Aortic Dissection: A life-threatening condition that requires immediate attention, aortic dissection can cause severe, tearing chest pain that radiates 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: A condition where fluid accumulates in the pericardial sac, cardiac tamponade can cause chest pain, shortness of breath, and hypotension.
- Esophageal Rupture: A rare but life-threatening condition, esophageal rupture can cause severe chest pain, vomiting, and difficulty swallowing.
Rare Diagnoses
- Pericarditis: Inflammation of the pericardium can cause chest pain that's often sharp and stabbing.
- Pneumothorax: A collapsed lung can cause chest pain, shortness of breath, and decreased lung sounds on the affected side.
- Mitral Valve Prolapse: A condition where the mitral valve doesn't close properly, mitral valve prolapse can cause chest pain, palpitations, and shortness of breath.
- Thoracic Aortic Aneurysm: A rare condition where the aorta dilates, thoracic aortic aneurysm can cause chest pain, back pain, and shortness of breath.