Differential Diagnosis for Right Sided Pleuritic Chest Pain
Single Most Likely Diagnosis
- Pulmonary Embolism: This is often considered the most likely diagnosis for pleuritic chest pain due to its relatively high prevalence and the fact that it can present with sudden onset of sharp, stabbing pain that worsens with deep breathing or coughing. The pain is typically unilateral and can be accompanied by other symptoms such as dyspnea, tachypnea, and tachycardia.
Other Likely Diagnoses
- Pneumonia: Can cause pleuritic chest pain, especially if the infection involves the pleura. Symptoms may include fever, cough, sputum production, and shortness of breath.
- Pleurisy: Inflammation of the pleura that can result from various causes, including viral infections, pneumonia, and pulmonary embolism. It presents with sharp chest pain that worsens with breathing.
- Costochondritis: Inflammation of the cartilage that connects the ribs to the sternum, which can cause sharp pains in the chest that may worsen with deep breathing or movement.
Do Not Miss Diagnoses
- Pneumothorax: A potentially life-threatening condition where air leaks into the space between the lung and chest wall, which can cause sudden, severe pleuritic chest pain and shortness of breath. It requires immediate medical attention.
- Myocardial Infarction: Although typically associated with non-pleuritic chest pain, myocardial infarction can occasionally present with pleuritic pain, especially if the inferior wall of the heart is involved.
- Aortic Dissection: A serious condition where there is a tear in the aorta's inner layer, which can cause severe, tearing chest pain that may be pleuritic in nature and is often accompanied by other symptoms such as hypertension and neurological deficits.
Rare Diagnoses
- Pulmonary Infarction: While less common, pulmonary infarction can occur due to a pulmonary embolism and cause pleuritic chest pain.
- Diaphragmatic Pleurisy: Inflammation of the diaphragmatic pleura, which can be caused by conditions such as pneumonia or pulmonary embolism, leading to pleuritic chest pain.
- Lung Cancer: Although rare as a cause of acute pleuritic chest pain, lung cancer can cause pleuritic pain if it invades the pleura or causes a malignant pleural effusion.