Differential Diagnosis for Chest Pain, SOB, and Nausea Radiating to Left Back 3 Days After PCI
- Single Most Likely Diagnosis
- Stent thrombosis: This is a highly likely diagnosis given the recent PCI and the presentation of chest pain radiating to the left back. Stent thrombosis is a serious complication that can occur early after stent placement and presents with symptoms similar to myocardial infarction.
- Other Likely Diagnoses
- Myocardial infarction (not related to stent thrombosis): Although the patient had a recent PCI, there's still a possibility of having a myocardial infarction in a different coronary segment.
- Pericarditis: This could be a complication following the PCI procedure, especially if there was instrumentation of the coronary arteries or if there was a minor perforation.
- Pulmonary embolism: Although less directly related to the recent PCI, pulmonary embolism can cause chest pain, shortness of breath, and nausea, and should be considered, especially if there are risk factors for venous thromboembolism.
- Do Not Miss Diagnoses
- Aortic dissection: This is a life-threatening condition that can present with chest pain radiating to the back. Although it's less common, the severity of the condition necessitates its consideration, especially if there are risk factors such as hypertension or aortic pathology.
- Esophageal rupture: This is a rare but potentially fatal condition that could present with chest pain and nausea, especially if there was recent instrumentation of the esophagus or if the patient has a history of severe esophageal disease.
- Rare Diagnoses
- Pneumothorax: This could be a complication if there was a procedure-related injury to the lung or if the patient has underlying lung disease.
- Coronary artery dissection: A rare complication that could occur after PCI, presenting with chest pain.
- Gastroesophageal reflux disease (GERD) exacerbation: Although less likely given the acute presentation and recent PCI, severe GERD could cause chest pain and nausea, but it would be less likely to radiate to the back in a manner suggestive of cardiac or aortic issues.