Differential Diagnosis for Chest Pain
The following is a differential diagnosis for chest pain, categorized for clarity and emphasis on critical conditions.
- Single Most Likely Diagnosis
- Gastroesophageal Reflux Disease (GERD): This is often the most common cause of chest pain, especially if the pain is related to eating or lying down. GERD symptoms can mimic cardiac issues, making it a first consideration to rule out due to its prevalence.
- Other Likely Diagnoses
- Musculoskeletal Pain: Strains or inflammation in the muscles or bones of the chest wall can cause significant pain, often related to movement or position.
- Asthma or Chronic Obstructive Pulmonary Disease (COPD) Exacerbation: Respiratory conditions can lead to chest pain, especially if there's associated coughing or shortness of breath.
- Pulmonary Embolism: While less common than other respiratory issues, pulmonary embolism is a critical condition that presents with sudden onset of chest pain and shortness of breath.
- Do Not Miss Diagnoses
- Myocardial Infarction (MI): Heart attack is a medical emergency that requires immediate attention. The pain is typically described as a squeezing sensation and can radiate to the arm, neck, or jaw.
- Aortic Dissection: A tear in the aorta's inner layer can cause severe, tearing chest pain that radiates to the back. It's a rare but life-threatening condition.
- Pneumothorax: Air in the pleural space can cause the lung to collapse, leading to sudden chest pain and shortness of breath. It's critical to diagnose and treat promptly.
- Rare Diagnoses
- Pericarditis: Inflammation of the pericardium, the sac surrounding the heart, can cause sharp chest pain that improves with sitting up and leaning forward.
- Esophageal Spasm or Rupture: These conditions are less common but can cause severe chest pain. Esophageal rupture is a medical emergency.
- Pulmonary Artery Hypertension: Elevated blood pressure in the pulmonary arteries can lead to chest pain, among other symptoms, due to right heart strain.
Each of these diagnoses has distinct characteristics and risk factors, and a thorough medical history, physical examination, and diagnostic tests are essential for an accurate diagnosis.