Differential Diagnosis for 53 y/o Male with Chest Pain
- Single Most Likely Diagnosis
- Acute Coronary Syndrome (ACS): This is the most likely diagnosis given the patient's age and symptom of chest pain. ACS, including myocardial infarction, is a common cause of chest pain in middle-aged males.
- Other Likely Diagnoses
- Gastroesophageal Reflux Disease (GERD): GERD is a common condition that can cause chest pain, especially if the pain is related to eating or relieved by antacids.
- Musculoskeletal Pain: Musculoskeletal issues, such as costochondritis or muscle strain, can cause chest pain and are relatively common.
- Pulmonary Embolism (PE): While less common than ACS, PE is a significant cause of chest pain, especially if the patient has risk factors such as recent travel, immobility, or cancer.
- Pneumonia or Pneumonitis: Infections of the lung can cause chest pain, especially if the pain is accompanied by cough, fever, or shortness of breath.
- Do Not Miss Diagnoses
- Aortic Dissection: A life-threatening condition where the inner layer of the aorta tears, causing severe chest pain. It is crucial to consider this diagnosis, especially if the pain is severe, tearing, or radiates to the back.
- Pulmonary Embolism (also listed under other likely diagnoses, but included here due to its high mortality if missed): The risk of missing PE is significant, and it can be deadly, making it essential to consider in any patient with chest pain.
- Esophageal Rupture: A rare but life-threatening condition that requires immediate surgical intervention. It typically presents with severe chest pain after vomiting or eating.
- Rare Diagnoses
- Pericarditis: Inflammation of the pericardium, the sac surrounding the heart, can cause chest pain. It is less common but should be considered, especially if the pain improves with leaning forward.
- Mediastinitis: Inflammation of the tissues in the mediastinum, which can be caused by infection or other conditions, is a rare cause of chest pain.
- Spontaneous Pneumothorax: A rare condition where air leaks into the space between the lung and chest wall, causing chest pain and shortness of breath, especially in tall, thin males.