Differential Diagnosis for Chest Tightness and Vomiting at 31 Weeks of Pregnancy
Single Most Likely Diagnosis
- Gastroesophageal Reflux Disease (GERD): This condition is common in pregnancy, especially in the third trimester, due to increased intra-abdominal pressure and relaxation of the lower esophageal sphincter. Symptoms include chest tightness or discomfort and vomiting.
Other Likely Diagnoses
- Pregnancy-induced Hypertension: Can cause chest tightness and vomiting, among other symptoms. It's a condition that needs monitoring and management to prevent complications.
- Pre-eclampsia: A condition characterized by high blood pressure and often accompanied by protein in the urine, which can lead to more severe complications if not addressed. Chest tightness and vomiting can be part of the symptomatology.
- Viral Gastroenteritis: Although less specific to pregnancy, viral gastroenteritis can cause vomiting and, in some cases, chest tightness if there's associated esophageal irritation.
Do Not Miss Diagnoses
- Pulmonary Embolism (PE): A potentially life-threatening condition that requires immediate diagnosis and treatment. Symptoms can include sudden onset of chest pain or tightness and may be accompanied by vomiting due to the body's stress response.
- Myocardial Infarction (MI): Although less common in younger pregnant women, MI can occur and presents with chest pain or tightness. Vomiting can be associated due to the pain or as part of the body's response to decreased cardiac output.
- Aortic Dissection: A rare but critical condition where there is a tear in the aorta's inner layer. It can cause severe chest pain or tightness and vomiting, among other symptoms.
Rare Diagnoses
- Esophageal Rupture or Perforation: A rare condition that can cause severe chest pain and vomiting. It's more likely to occur in the context of forceful vomiting or an underlying esophageal condition.
- Acute Coronary Syndrome due to Spontaneous Coronary Artery Dissection (SCAD): A rare cause of myocardial infarction that is more common in pregnant women, especially in the third trimester or postpartum. It presents with chest pain or tightness and possibly vomiting.