Differential Diagnosis for Upper Left Quadrant Pain while Breathing

Single Most Likely Diagnosis

• Pleurisy: This condition, which is inflammation of the pleura (the two-layered membrane surrounding the lungs and lining the chest cavity), can cause sharp pain in the chest that worsens with breathing. The upper left quadrant is a common location for this type of pain due to the anatomy of the lungs and pleura.

Other Likely Diagnoses

• Pneumonia: An infection in the lung can cause pain in the chest that is worse with deep breathing or coughing. The upper left lobe of the lung is a common site for pneumonia, which could explain the location of the pain.
• Pulmonary Embolism (small): While often presenting with more severe symptoms, a small pulmonary embolism (a blood clot in the lungs) could cause localized pain that worsens with breathing, depending on its location.
• Costochondritis: Inflammation of the cartilage that connects the ribs to the breastbone (sternum) can cause chest pain that may be exacerbated by breathing, especially if the inflammation is located on the left side.

Do Not Miss Diagnoses

• Pneumothorax: A collapsed lung, where air leaks into the space between the lung and chest wall, can cause sudden, severe chest pain that worsens with breathing. It's a medical emergency that requires immediate attention.
• Myocardial Infarction (Heart Attack): Although more commonly associated with central chest pain, a heart attack can sometimes present with pain in other areas, including the upper left quadrant, especially if the inferior wall of the heart is involved.
• Aortic Dissection: A tear in the aorta's inner layer can cause severe, tearing chest pain that can radiate to the back and may worsen with breathing. It's a life-threatening condition that requires immediate medical intervention.

Rare Diagnoses

• Lung Cancer: While not typically the first consideration for acute pain with breathing, lung cancer can cause localized pain if a tumor is pressing on the pleura or chest wall.
• Diaphragmatic Hernia: A rare condition where part of the stomach or intestine bulges up into the chest through an opening in the diaphragm, which can cause chest pain that worsens with breathing.
• Sickle Cell Crisis: In individuals with sickle cell disease, a crisis can cause episodes of acute pain, including chest pain, due to vaso-occlusion in the lungs.