Differential Diagnosis for Sharp Non-Cardiac Left Sided Chest Pain

Single Most Likely Diagnosis

• Musculoskeletal Pain: This is often the most common cause of sharp, non-cardiac chest pain, resulting from strain or injury to the muscles or ribs on the left side of the chest. The pain is typically exacerbated by movement or deep breathing.

Other Likely Diagnoses

• Pulmonary Embolism (PE): Although more commonly associated with right-sided chest pain, a pulmonary embolism can cause sharp pain on either side, depending on the location of the embolus. The pain is often worsened by deep breathing.
• Pneumonia or Pleuritis: Inflammation of the lung tissue or the pleura can cause sharp, stabbing pain that worsens with breathing or coughing. The pain can be localized to one side, depending on the area affected.
• Gastroesophageal Reflux Disease (GERD): GERD can cause sharp chest pain, especially after eating or at night, due to stomach acid refluxing into the esophagus. The pain can be perceived on the left side due to the esophagus's location.

Do Not Miss Diagnoses

• Aortic Dissection: A life-threatening condition where the inner layer of the aorta tears, causing severe, sharp pain that can radiate to the back or chest. Although it's more central, it can present with left-sided chest pain.
• Pneumothorax: Air in the pleural space can cause sharp, stabbing pain on one side of the chest, which worsens with deep breathing. It's crucial to diagnose promptly as it can lead to respiratory distress.
• Esophageal Rupture: A rare but critical condition where the esophagus tears, leading to severe chest pain, often accompanied by difficulty swallowing or vomiting. The pain can be sharp and localized to the left side.

Rare Diagnoses

• Diaphragmatic Hernia: A condition where part of the stomach or intestine bulges through an opening in the diaphragm, which can cause sharp, left-sided chest pain, especially after eating.
• Splenic Infarction or Rupture: Although rare, these conditions can cause severe, sharp left upper quadrant or chest pain due to the spleen's location under the left lower ribs.
• Pancreatitis: Inflammation of the pancreas can cause severe, sharp abdominal pain that radiates to the back or chest, potentially perceived as left-sided chest pain.