Differential Diagnosis for Intermittent Sharp Left Sided Chest and Axillary Pain in a 14 Weeks Pregnant Woman

• Single Most Likely Diagnosis
  • Costochondritis: This condition, also known as Tietze's syndrome, is characterized by sharp pains in the chest and axilla due to inflammation of the cartilages and bones in the chest wall. It is relatively common, especially during pregnancy due to hormonal changes and increased stress on the musculoskeletal system. The intermittent and sharp nature of the pain, lasting only seconds, aligns with costochondritis.
• Other Likely Diagnoses
  • Musculoskeletal Strain: Pregnancy can lead to changes in posture and increased weight, which may strain the muscles and joints of the chest and axillary region, causing sharp pains.
  • Gastroesophageal Reflux Disease (GERD): Although more commonly associated with burning chest pain, GERD can sometimes cause sharp pains, especially if the esophagus is irritated. Pregnancy can exacerbate GERD symptoms.
• Do Not Miss Diagnoses
  • Pulmonary Embolism (PE): Although less likely given the description of the pain, PE is a life-threatening condition that must be considered, especially in pregnant women who are at increased risk due to hypercoagulability. The pain from PE can sometimes be sharp and localized.
  • Myocardial Infarction (MI): While rare in young pregnant women, MI can occur and may present with atypical symptoms, including sharp chest pain. It is crucial to rule out MI due to its high mortality rate if untreated.
• Rare Diagnoses
  • Pneumothorax: A collapsed lung can cause sharp chest pain but is less common in pregnant women without underlying lung disease or trauma.
  • Pericarditis: Inflammation of the pericardium can cause sharp chest pain, but it is relatively rare and might be accompanied by other symptoms like fever and a pericardial friction rub.