Differential Diagnosis for Mid Abdominal Tightness and Pressure
The symptoms described, such as mid abdominal tightness feeling like compression bandages or pressure applied to the chest, with worsening pain over the day, can be attributed to various causes. Here's a categorized differential diagnosis:
- Single Most Likely Diagnosis
- Gastroesophageal Reflux Disease (GERD): This condition involves stomach acid frequently flowing back into the tube connecting the mouth and stomach (esophagus). The symptoms can include a tight feeling in the chest and abdomen, especially after eating, which can worsen over the day due to increased acid production and food intake.
- Other Likely Diagnoses
- Costochondritis: Inflammation of the cartilage that connects a rib to the breastbone (sternum), which can cause sharp pains or a dull ache in the chest and upper abdominal area, feeling like pressure or tightness.
- Musculoskeletal Strain: Overuse or injury to the muscles in the abdominal or chest wall can lead to pain and tightness, especially if the pain worsens with movement or at the end of the day.
- Irritable Bowel Syndrome (IBS): A disorder affecting the large intestine, causing a variety of symptoms including abdominal pain, cramping, and changes in bowel movements, which can sometimes feel like tightness or pressure.
- Do Not Miss Diagnoses
- Myocardial Infarction (Heart Attack): Although less common in younger individuals without risk factors, chest pain or discomfort that feels like pressure, tightness, or heaviness, which may radiate to the abdomen, is a critical symptom that should not be overlooked.
- Pulmonary Embolism: A blockage in one of the arteries in the lungs, which can cause sudden and severe chest pain that may feel like pressure or tightness, and can be life-threatening if not promptly treated.
- Aortic Dissection: A serious condition where there is a tear in the inner layer of the aorta, leading to severe, tearing chest pain that can radiate to the abdomen, and requires immediate medical attention.
- Rare Diagnoses
- Pancreatitis: Inflammation of the pancreas, which can cause severe abdominal pain that radiates to the back and may feel like tightness or pressure in the upper abdomen.
- Splenic Infarction: A condition where the spleen does not receive enough blood flow, leading to tissue death, which can cause severe abdominal pain, sometimes feeling like pressure or tightness, especially in the upper left region.
- Gastric Volvulus: A rare condition where the stomach twists abnormally, which can cause severe abdominal pain, nausea, and vomiting, and may feel like tightness or pressure in the upper abdomen.