Chest Tightness Differential Diagnosis
The following is a differential diagnosis for chest tightness, categorized for clarity and emphasis on critical conditions.
- Single Most Likely Diagnosis
- Anxiety or Panic Attack: Often presents with chest tightness, shortness of breath, and can mimic more serious conditions. The psychological component and the absence of other alarming symptoms make this a common initial consideration.
- Other Likely Diagnoses
- Gastroesophageal Reflux Disease (GERD): Can cause chest tightness or discomfort, especially after eating or at night, due to acid reflux.
- Musculoskeletal Pain: Strained muscles or costochondritis (inflammation of the cartilage that connects the ribs to the breastbone) can cause chest tightness or pain.
- Asthma or Chronic Obstructive Pulmonary Disease (COPD): Both conditions can lead to chest tightness, especially during exacerbations or if not well-controlled.
- Do Not Miss Diagnoses
- Myocardial Infarction (Heart Attack): Although less common, chest tightness or pain can be a symptom of a heart attack, especially if accompanied by other symptoms like arm pain, jaw pain, or shortness of breath.
- Pulmonary Embolism: A blood clot in the lungs can cause sudden chest pain or tightness, often accompanied by shortness of breath and possibly coughing up blood.
- Aortic Dissection: A tear in the aorta's inner layer can cause severe, tearing chest pain or tightness, which is a medical emergency.
- Rare Diagnoses
- Pneumothorax: A collapsed lung can cause sudden chest pain or tightness, often with shortness of breath.
- Pericarditis: Inflammation of the sac surrounding the heart can cause chest pain or tightness that may improve with leaning forward.
- Esophageal Spasm or Rupture: Although rare, these conditions can cause severe chest pain or tightness, often related to eating or swallowing.
Each diagnosis has a unique set of accompanying symptoms and risk factors that can help guide the differential diagnosis. A thorough medical history, physical examination, and appropriate diagnostic tests are crucial for accurately diagnosing the cause of chest tightness.