Differential Diagnosis for Chest Pain and Shortness of Breath
Single Most Likely Diagnosis
- Acute Coronary Syndrome (ACS): This is often the first consideration for chest pain and shortness of breath, especially in patients with risk factors for coronary artery disease. The symptoms can be indicative of a myocardial infarction (heart attack) or unstable angina.
Other Likely Diagnoses
- Pulmonary Embolism (PE): A blood clot in the lungs can cause sudden onset of chest pain and shortness of breath. Risk factors include recent surgery, immobilization, cancer, and genetic predispositions to clotting.
- Pneumonia: Infection in the lungs can lead to inflammation, which may cause chest pain and difficulty breathing. Symptoms can also include fever, cough, and sputum production.
- Asthma or Chronic Obstructive Pulmonary Disease (COPD) Exacerbation: For patients with a history of asthma or COPD, an exacerbation can lead to increased shortness of breath and chest tightness or pain.
- Pneumothorax: Air in the pleural space can cause the lung to collapse partially or completely, leading to sudden chest pain and shortness of breath.
Do Not Miss Diagnoses
- Aortic Dissection: A tear in the aorta's inner layer can cause severe, tearing chest pain and shortness of breath. It's critical to diagnose promptly as it can be fatal if not treated immediately.
- Pulmonary Embolism in Pregnancy: Pregnancy increases the risk of blood clots, and a pulmonary embolism can be particularly dangerous for both the mother and the fetus.
- Cardiac Tamponade: Fluid accumulation in the pericardial sac can compress the heart, leading to impaired filling and reduced cardiac output, causing chest pain and shortness of breath.
Rare Diagnoses
- Mitral Valve Prolapse with Severe Regurgitation: Although more commonly associated with murmurs, in rare cases, it can lead to acute symptoms if there's significant regurgitation.
- Spontaneous Hemopneumothorax: Air and blood in the pleural space not due to trauma, which can cause sudden onset of symptoms.
- Eosinophilic Pneumonia: A rare condition characterized by an accumulation of eosinophils in the lungs, which can cause chest pain and shortness of breath among other symptoms.