Differential Diagnosis for Intermittent Chest Pain
Single Most Likely Diagnosis
- Costochondritis: This condition, also known as Tietze's syndrome, is characterized by inflammation of the cartilage that connects the ribs to the breastbone, leading to sharp pains or aches. It's a common cause of chest pain in young adults, especially after strenuous exercise or heavy lifting, and matches the description of squeezing chest pain.
Other Likely Diagnoses
- Gastroesophageal Reflux Disease (GERD): GERD can cause chest pain that is often described as squeezing or burning, usually after eating or at night. It's a common condition that can affect anyone, regardless of age.
- Musculoskeletal Pain: Strained muscles or inflammation in the chest wall can cause pain that feels like it's coming from the chest. This could be due to overuse, poor posture, or direct injury to the area.
- Anxiety or Panic Disorder: These conditions can manifest with physical symptoms, including chest pain or discomfort that may feel like squeezing. The pain is often sharp and can be accompanied by other symptoms like shortness of breath, palpitations, and fear of losing control.
Do Not Miss Diagnoses
- Acute Coronary Syndrome (ACS): Although less common in young, healthy females without pre-existing conditions, ACS (including myocardial infarction) is a critical diagnosis that must not be missed. Risk factors such as family history of early heart disease, smoking, or use of certain drugs (e.g., cocaine) could increase the likelihood.
- Pulmonary Embolism (PE): This is a potentially life-threatening condition where a blood clot blocks an artery in the lung. It can cause sudden, sharp chest pain that worsens with deep breathing, and is more likely in individuals with recent long-distance travel, immobilization, or family history of clotting disorders.
- Aortic Dissection: A tear in the inner layer of the aorta can cause severe, tearing chest pain that radiates to the back. It's rare but critical and more common in individuals with hypertension, aortic aneurysm, or certain genetic conditions like Marfan syndrome.
Rare Diagnoses
- Pericarditis: Inflammation of the pericardium, the sac surrounding the heart, can cause sharp, stabbing chest pain that may improve with sitting up and leaning forward. It's less common and can be associated with viral infections, autoimmune diseases, or post-myocardial infarction.
- Pneumothorax: Air in the space between the lungs and chest wall can cause sudden, sharp chest pain and shortness of breath. It's more common in tall, thin males or individuals with lung disease but can occur in anyone, especially after trauma.
- Esophageal Spasm: Abnormal muscle contractions of the esophagus can cause chest pain that feels like squeezing or heavy pressure. It's relatively rare and can be associated with conditions like gastroesophageal reflux disease or esophageal motility disorders.