Differential Diagnosis for Chest Pain during Blood Transfusion
- Single most likely diagnosis
- Transfusion-related acute lung injury (TRALI): This is a leading cause of transfusion-related mortality and morbidity. Chest pain during blood transfusion could be indicative of TRALI, especially if accompanied by other symptoms such as non-cardiogenic pulmonary edema, hypoxemia, and bilateral infiltrates on chest radiograph.
- Other Likely diagnoses
- Allergic reaction: An allergic reaction to the blood transfusion could manifest as chest pain, along with other symptoms like urticaria, itching, and difficulty breathing.
- Anaphylaxis: A severe, life-threatening allergic reaction that could cause chest pain, among other symptoms such as hypotension, tachycardia, and respiratory distress.
- Hemolytic transfusion reaction: Although more commonly associated with symptoms like fever, chills, and hemoglobinuria, a severe hemolytic reaction could potentially cause chest pain due to the release of inflammatory mediators.
- Do Not Miss (ddxs that may not be likely, but would be deadly if missed.)
- Pulmonary embolism: Although less common in the context of blood transfusion, a pulmonary embolism could cause sudden onset of chest pain and would be catastrophic if missed.
- Cardiac tamponade: If the chest pain is due to a perforated myocardial infarction or other cardiac condition, it could lead to cardiac tamponade, which is life-threatening.
- Aortic dissection: A rare but potentially fatal condition that could cause chest pain and would require immediate intervention.
- Rare diagnoses
- Air embolism: Although rare, air embolism during blood transfusion could cause chest pain and other respiratory symptoms.
- Septic transfusion reaction: Bacterial contamination of the blood product could lead to a septic reaction, which might include chest pain among its symptoms.