Differential Diagnosis for Cough and Chest Pain
The symptoms of cough, chest pain when coughing, and common flu-like symptoms can be caused by various conditions. Here's a differential diagnosis organized into categories:
- Single most likely diagnosis
- Acute Bronchitis: This is a common condition that causes cough and chest discomfort, especially when coughing. It often presents with other flu-like symptoms such as fever, fatigue, and sore throat. The symptoms usually resolve on their own within a week or two.
- Other Likely diagnoses
- Pneumonia: An infection of the lungs that can cause cough, chest pain (pleuritic chest pain), and flu-like symptoms. The presence of fever, chills, and shortness of breath may suggest pneumonia.
- Influenza: The flu can cause cough, chest discomfort, and other respiratory symptoms. The cough may not be as prominent as in bronchitis, but the presence of high fever, body aches, and fatigue is common.
- Asthma: Asthma can cause cough, chest tightness, and shortness of breath, especially if triggered by a respiratory infection. Wheezing and variability of symptoms are key features.
- Do Not Miss (ddxs that may not be likely, but would be deadly if missed.)
- Pulmonary Embolism (PE): Although less common, PE is a life-threatening condition that can cause sudden onset of chest pain and cough. Risk factors such as recent travel, immobilization, or family history of clotting disorders increase the suspicion.
- Pneumothorax: A collapsed lung can cause sudden chest pain and cough. It's more common in tall, thin males or those with underlying lung disease.
- Myocardial Infarction (MI): Chest pain is a hallmark of MI, but it can occasionally present with cough and flu-like symptoms, especially in older adults or those with diabetes.
- Rare diagnoses
- Lung Cancer: Although rare in the context of acute symptoms, lung cancer can cause cough and chest pain, especially if the tumor involves the pleura or chest wall.
- Tuberculosis (TB): TB can cause chronic cough, chest pain, and systemic symptoms like fever and weight loss. It's more common in immunocompromised individuals or those from endemic areas.
- Pleurisy: Inflammation of the pleura can cause sharp chest pain that worsens with coughing or deep breathing. It can be caused by various conditions, including infections, autoimmune diseases, or pulmonary embolism.