Differential Diagnosis for Chest Pain with Shortness of Breath
Single Most Likely Diagnosis
- Chronic Obstructive Pulmonary Disease (COPD) Exacerbation: This is the most likely diagnosis given the long-standing history of symptoms that have worsened over the last month. COPD is a progressive lung disease characterized by chronic inflammation and airflow limitation in the lungs, which can cause chest pain and shortness of breath.
Other Likely Diagnoses
- Asthma: Similar to COPD, asthma is a chronic inflammatory disease of the airways that can cause recurring episodes of wheezing, chest tightness, shortness of breath, and coughing. The increase in symptoms over the last month could indicate an asthma exacerbation.
- Chronic Heart Failure: This condition occurs when the heart is unable to pump enough blood to meet the body's needs. It can cause symptoms such as shortness of breath, fatigue, and chest pain, especially if the condition has worsened over time.
- Gastroesophageal Reflux Disease (GERD): GERD can cause chest pain and shortness of breath, especially if stomach acid flows up into the esophagus and irritates the lungs.
Do Not Miss Diagnoses
- Pulmonary Embolism (PE): Although less likely given the chronic nature of the symptoms, a pulmonary embolism is a life-threatening condition that requires immediate attention. It occurs when a blood clot lodges in the lungs' blood vessels, causing sudden and severe shortness of breath and chest pain.
- Myocardial Infarction (MI): Also known as a heart attack, MI occurs when the blood flow to the heart is blocked, causing damage to the heart muscle. It is a medical emergency that can present with chest pain and shortness of breath.
- Pneumonia: An infection in the lungs that can cause cough, fever, chest pain, and shortness of breath. While it might not be the first consideration for chronic symptoms, a severe case could present similarly.
Rare Diagnoses
- Pulmonary Arterial Hypertension (PAH): A rare and progressive disease characterized by high blood pressure in the arteries of the lungs, leading to right heart failure. Symptoms include shortness of breath, chest pain, and fatigue.
- Sarcoidosis: An inflammatory disease that affects multiple organs in the body, including the lungs, and can cause symptoms such as shortness of breath and chest pain.
- Lymphangitic Carcinomatosis: A rare condition where cancer spreads to the lymphatic vessels in the lungs, causing shortness of breath and chest pain.