Differential Diagnosis for Chest Pain
- 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 arm, neck, or jaw.
- Other Likely diagnoses
- Gastroesophageal Reflux Disease (GERD): Chest pain can be a symptom of GERD, especially if it is accompanied by regurgitation, dysphagia, or a sour taste in the mouth. The pain is often described as a burning sensation in the chest.
- Musculoskeletal pain: Chest pain can be caused by musculoskeletal issues such as costochondritis, muscle strain, or rib fractures. The pain is often sharp and localized to a specific area.
- Pulmonary embolism: While less common than ACS, pulmonary embolism can cause sudden onset of chest pain, especially if it is accompanied by shortness of breath, cough, or hemoptysis.
- Do Not Miss (ddxs that may not be likely, but would be deadly if missed.)
- Aortic dissection: A tear in the aorta can cause severe, tearing chest pain that radiates to the back. It is a medical emergency that requires immediate attention.
- Pulmonary embolism: As mentioned earlier, pulmonary embolism can cause sudden onset of chest pain and is a life-threatening condition if not treated promptly.
- Cardiac tamponade: Fluid accumulation in the pericardial sac can cause chest pain, shortness of breath, and hypotension. It is a medical emergency that requires immediate attention.
- Rare diagnoses
- Pneumothorax: A collapsed lung can cause sudden onset of chest pain and shortness of breath. It is more common in tall, thin individuals or those with underlying lung disease.
- Esophageal rupture: A tear in the esophagus can cause severe chest pain, especially if it is accompanied by vomiting, fever, or difficulty swallowing.
- Hypertrophic cardiomyopathy: A genetic disorder that causes thickening of the heart muscle can lead to chest pain, especially during exercise or strenuous activity.