Differential Diagnosis for Chest Pain with History of Asthma
- Single most likely diagnosis
- Asthma exacerbation: The patient's history of asthma and the presence of hyperinflation associated with air trapping on the imaging study strongly suggest an asthma exacerbation as the cause of the chest pain.
- Other Likely diagnoses
- Pulmonary embolism: Although there is no evidence of focal consolidation or pleural fluid, pulmonary embolism can present with chest pain and should be considered, especially if the patient has risk factors.
- Pneumonia: Despite the lack of focal consolidation, atypical pneumonia or early pneumonia could be a consideration, especially if the patient has symptoms such as fever or cough.
- Musculoskeletal pain: The chest pain could be musculoskeletal in origin, especially if the patient has a history of trauma or strain.
- Do Not Miss (ddxs that may not be likely, but would be deadly if missed.)
- Aortic dissection: Although the atheromatous changes of the thoracic aorta are noted, aortic dissection is a life-threatening condition that must be considered in the differential diagnosis of chest pain.
- Pneumothorax: The absence of pleural fluid does not rule out pneumothorax, which can be life-threatening and requires prompt diagnosis and treatment.
- Rare diagnoses
- Lung cancer: The 4 mm nodule in the left midlung field is small, but it could be a malignancy, especially if the patient has risk factors such as smoking.
- Sarcoidosis: This condition can cause chest pain and lung nodules, although it is less likely given the patient's history and the absence of other findings suggestive of sarcoidosis.
- Eosinophilic pneumonia: This rare condition can cause chest pain and lung infiltrates, although it is less likely given the patient's presentation and the absence of other findings suggestive of eosinophilic pneumonia.