Differential Diagnosis for Esophageal Cause of Chest Pain

• Single most likely diagnosis
  • Gastroesophageal reflux disease (GERD): This is the most common esophageal cause of chest pain. The symptoms of GERD, such as heartburn and regurgitation, can often be mistaken for cardiac chest pain, making it a likely consideration in the differential diagnosis.
• Other Likely diagnoses
  • Esophageal spasm: This condition involves abnormal muscle contractions of the esophagus, which can cause chest pain. It is often associated with difficulty swallowing and can be triggered by certain foods or stress.
  • Esophagitis: Inflammation of the esophagus, often due to acid reflux or infection, can cause chest pain, difficulty swallowing, and bleeding.
• Do Not Miss (ddxs that may not be likely, but would be deadly if missed.)
  • Esophageal rupture (Boerhaave's syndrome): A rare but life-threatening condition where the esophagus tears, often due to severe vomiting or retching. It requires immediate medical attention.
  • Esophageal cancer: Although less common, esophageal cancer can cause chest pain, difficulty swallowing, and weight loss. Early detection is crucial for treatment.
• Rare diagnoses
  • Achalasia: A rare disorder of the esophagus where the muscles are unable to move food into the stomach, leading to difficulty swallowing, regurgitation, and sometimes chest pain.
  • Eosinophilic esophagitis: A chronic inflammatory condition of the esophagus that can cause difficulty swallowing, food impaction, and chest pain, often associated with allergies or asthma.
  • Nutcracker esophagus: A rare condition characterized by powerful muscle contractions of the esophagus, which can cause chest pain and difficulty swallowing.