Differential Diagnosis for Chest Pain Radiating into Left Arm
- Single Most Likely Diagnosis
- Myocardial Infarction (MI): This is the most common cause of chest pain radiating to the left arm, often described as a squeezing or pressure sensation. The radiation of pain to the left arm is due to the shared nerve supply (T1-T5) between the heart and the arm.
- Other Likely Diagnoses
- Angina Pectoris: Similar to MI, angina is caused by reduced blood flow to the heart muscle, leading to chest pain that can radiate to the left arm. It is typically precipitated by exertion or emotional stress and relieved by rest.
- Gastroesophageal Reflux Disease (GERD): GERD can cause chest pain that may radiate to the arms, though it more commonly presents with symptoms of heartburn and regurgitation.
- Musculoskeletal Pain: Conditions like costochondritis (inflammation of the cartilage that connects the ribs to the breastbone) or muscle strain can cause chest pain that radiates to the arm, especially with movement.
- Do Not Miss Diagnoses
- Pulmonary Embolism (PE): Although less common, PE can cause sudden onset chest pain that may radiate to the arms, accompanied by shortness of breath, tachypnea, and possibly syncope. It is crucial to consider PE due to its high mortality rate if untreated.
- Aortic Dissection: This is a life-threatening condition where there is a tear in the aorta's inner layer. It can cause severe, tearing chest pain that radiates to the back or arms. Immediate diagnosis and treatment are critical.
- Esophageal Rupture: A rare but dangerous condition that can cause severe chest pain radiating to the back or arms, often accompanied by difficulty swallowing or vomiting.
- Rare Diagnoses
- Pneumothorax: Air in the pleural space can cause chest pain that may radiate to the arms, typically accompanied by shortness of breath and decreased breath sounds on the affected side.
- Pericarditis: Inflammation of the pericardium, the sac surrounding the heart, can cause sharp chest pain that may improve with sitting up and leaning forward. It can occasionally radiate to the arms.
- Thoracic Outlet Syndrome: Compression of the nerves or blood vessels that pass into the thoracic outlet (the space between your collarbone and first rib) can cause pain in your shoulders and neck that may radiate down your arm.