Differential Diagnosis for Referred Pain under the Sternum
Single Most Likely Diagnosis
- Gastroesophageal reflux disease (GERD): This condition is a common cause of chest pain and discomfort, often felt under the sternum. The pain is usually related to eating and can be accompanied by regurgitation and dysphagia.
Other Likely Diagnoses
- Gastritis: Inflammation of the stomach lining can cause pain and discomfort in the upper abdomen and under the sternum.
- Peptic ulcer disease: Ulcers in the stomach or duodenum can cause pain that radiates to the area under the sternum.
- Costochondritis: Inflammation of the cartilage that connects the ribs to the sternum can cause sharp pains and tenderness in the chest wall, including under the sternum.
Do Not Miss Diagnoses
- Myocardial infarction (MI): Although the pain of an MI is typically described as radiating to the arm, jaw, or back, it can also be felt under the sternum. Missing this diagnosis can be fatal.
- Pulmonary embolism: A blockage in one of the pulmonary arteries can cause sudden, severe chest pain that may be felt under the sternum, among other symptoms.
- Aortic dissection: A tear in the aorta can cause severe, tearing chest pain that can radiate to the back and under the sternum.
Rare Diagnoses
- Pancreatitis: Inflammation of the pancreas can cause severe abdominal pain that radiates to the back and under the sternum.
- Cholecystitis: Inflammation of the gallbladder can cause right upper quadrant pain that may radiate to the back and under the sternum in some cases.
- Esophageal spasm: Abnormal contractions of the esophagus can cause chest pain and discomfort under the sternum, often accompanied by difficulty swallowing.