Differential Diagnosis for Patient with Sarcoidosis and Chronic Feeling of Tightness and Squeezing around the Abdomen and Chest
Single Most Likely Diagnosis
- Sarcoidosis-related gastrointestinal or cardiac involvement: This is the most likely diagnosis given the patient's history of sarcoidosis. Sarcoidosis can affect various organs, including the gastrointestinal tract and the heart, leading to symptoms such as abdominal and chest tightness due to granulomatous inflammation.
Other Likely Diagnoses
- Gastroesophageal reflux disease (GERD): Chronic tightness and squeezing around the abdomen and chest could be symptoms of GERD, especially if the patient experiences heartburn or regurgitation. Sarcoidosis may not directly cause GERD, but the symptoms could coexist.
- Anxiety or panic disorder: The feeling of tightness and squeezing could also be related to anxiety or panic disorders, which might be exacerbated by the chronic nature of sarcoidosis.
- Musculoskeletal issues: Conditions like costochondritis or musculoskeletal strain could cause chest and abdominal wall pain, mimicking the sensation of tightness and squeezing.
Do Not Miss Diagnoses
- Cardiac sarcoidosis with myocardial involvement: Although less common, cardiac sarcoidosis can lead to serious complications, including heart failure and arrhythmias. The symptoms of chest tightness could be indicative of myocardial involvement.
- Pulmonary hypertension: Sarcoidosis can lead to pulmonary hypertension, which might cause chest tightness or discomfort due to right ventricular strain.
- Gastrointestinal obstruction or bowel ischemia: In rare cases, sarcoidosis can cause gastrointestinal obstruction or bowel ischemia, which would be medical emergencies.
Rare Diagnoses
- Eosinophilic gastroenteritis: A rare condition characterized by eosinophilic infiltration of the gastrointestinal tract, which could cause abdominal symptoms.
- Churg-Strauss syndrome: A form of vasculitis that can cause gastrointestinal and cardiac symptoms, although it is much rarer than sarcoidosis and typically associated with asthma and eosinophilia.
- Scleroderma: An autoimmune disease that can cause esophageal dysmotility and cardiac involvement, leading to similar symptoms, but it is distinct from sarcoidosis in its clinical presentation and autoimmune markers.