Differential Diagnosis for Achy Feeling in Left Chest to Left Shoulder

• Single most likely diagnosis
  • Musculoskeletal strain: This is often the most common cause of achy feelings in the chest and shoulder area, especially if the pain is exacerbated by movement or pressure. The pain can be referred from the muscles of the chest wall or the shoulder itself.
• Other Likely diagnoses
  • Gastroesophageal reflux disease (GERD): GERD can cause chest pain that may radiate to the shoulder, often described as a burning or achy sensation. This pain is typically worsened by lying down or eating certain foods.
  • Peptic ulcer disease: Similar to GERD, peptic ulcers can cause pain that radiates to the shoulder, often accompanied by nausea, vomiting, or relief with eating.
  • Costochondritis: Inflammation of the cartilage that connects the ribs to the breastbone can cause sharp pains or aching in the chest that may radiate to the shoulder.
• Do Not Miss (ddxs that may not be likely, but would be deadly if missed.)
  • Myocardial infarction (heart attack): Although less likely in younger populations without risk factors, myocardial infarction can present with atypical symptoms, including chest pain radiating to the shoulder. It is crucial to consider this diagnosis, especially in individuals with risk factors for coronary artery disease.
  • Pulmonary embolism: Sudden onset of chest pain that radiates to the shoulder, accompanied by shortness of breath, could indicate a pulmonary embolism, which is a life-threatening condition.
  • Aortic dissection: Severe, tearing chest pain that radiates to the back or shoulder can be indicative of an aortic dissection, a medical emergency.
• Rare diagnoses
  • Pneumonia or pleuritis: Inflammation of the lung tissue or the lining around the lungs can cause chest pain that may radiate to the shoulder, often accompanied by fever, cough, or shortness of breath.
  • Pancreatitis: Inflammation of the pancreas can cause severe abdominal pain that may radiate to the back or shoulder.
  • Spinal or thoracic vertebral fractures: Osteoporotic fractures or traumatic injuries to the spine can cause referred pain to the chest or shoulder area.