Differential Diagnosis for Sharp Chest Pain when Taking Deep Breath In

• Single most likely diagnosis
  • Pneumothorax: This condition, where air leaks into the space between the lung and chest wall, can cause sharp chest pain that worsens with deep breathing. The pain is typically unilateral and can be accompanied by shortness of breath.
• Other Likely diagnoses
  • Pulmonary embolism: While the pain associated with a pulmonary embolism can be sharp, it is more commonly described as dull and aching. However, the pain can worsen with deep breathing, making it a consideration.
  • Pleurisy: Inflammation of the pleura, the two-layered membrane surrounding the lungs, can cause sharp chest pain that worsens with deep breathing. This condition can be caused by a variety of factors, including viral infections, pneumonia, and autoimmune disorders.
  • Costochondritis: Inflammation of the cartilage that connects the ribs to the breastbone can cause sharp chest pain, especially with deep breathing or movement.
• Do Not Miss (ddxs that may not be likely, but would be deadly if missed.)
  • Aortic dissection: A tear in the inner layer of the aorta can cause severe, sharp chest pain that can radiate to the back. While the pain may not necessarily worsen with deep breathing, it is a life-threatening condition that requires immediate attention.
  • Myocardial infarction (heart attack): While chest pain associated with a heart attack is typically described as a pressure or heaviness, it can occasionally be sharp. It is essential to consider this diagnosis, especially in patients with risk factors.
• Rare diagnoses
  • Pneumomediastinum: Air in the mediastinum, the central part of the chest cavity, can cause sharp chest pain, especially with deep breathing. This condition is rare and often associated with trauma or lung disease.
  • Esophageal rupture: A tear in the esophagus can cause severe, sharp chest pain, especially with deep breathing or swallowing. This condition is rare but requires prompt medical attention.