Differential Diagnosis for Exertional Chest Pain
- Single most likely diagnosis
- Angina Pectoris: This is the most common cause of exertional chest pain, typically occurring in individuals with a history of coronary artery disease. The pain is usually described as a squeezing or pressure sensation in the chest, arm, or jaw, and is relieved by rest or nitroglycerin.
- Other Likely diagnoses
- Musculoskeletal Chest Pain: This can be caused by strain or injury to the muscles or joints in the chest wall, and is often reproducible with palpation or movement.
- Gastroesophageal Reflux Disease (GERD): GERD can cause chest pain that worsens with exertion, especially after eating or drinking certain foods.
- Asthma or Chronic Obstructive Pulmonary Disease (COPD): Exertional chest pain can be a symptom of asthma or COPD, especially if the individual has a history of respiratory disease.
- Do Not Miss (ddxs that may not be likely, but would be deadly if missed.)
- Myocardial Infarction (MI): Although angina is more common, MI is a life-threatening condition that requires immediate attention. The pain is often more severe and prolonged than angina.
- Pulmonary Embolism (PE): A PE can cause exertional chest pain, especially if the individual has a history of deep vein thrombosis or other risk factors.
- Aortic Dissection: This is a rare but life-threatening condition that can cause severe, tearing chest pain that radiates to the back.
- Rare diagnoses
- Hypertrophic Cardiomyopathy: This is a rare genetic disorder that can cause exertional chest pain, especially in young athletes.
- Pericarditis: Inflammation of the pericardium can cause chest pain that worsens with exertion, especially if the individual has a history of viral illness or autoimmune disease.
- Pneumothorax: A collapsed lung can cause exertional chest pain, especially if the individual has a history of lung disease or trauma.