Differential Diagnosis for Chest Pain
Single Most Likely Diagnosis
- Gastroesophageal Reflux Disease (GERD): This is often the most common cause of chest pain, especially if the pain is related to eating or relieved by antacids. The pain can mimic cardiac conditions, making it a crucial initial consideration.
Other Likely Diagnoses
- Musculoskeletal Pain: Strains or inflammation in the muscles or joints of the chest wall can cause significant pain, often reproducible by movement or palpation.
- Asthma or Chronic Obstructive Pulmonary Disease (COPD) Exacerbation: Respiratory conditions can cause chest pain, especially if there's associated coughing or shortness of breath.
- Pneumonia: Infection in the lungs can cause chest pain, typically accompanied by fever, cough, and difficulty breathing.
- Pulmonary Embolism: While less common, a blood clot in the lungs can cause sudden, severe chest pain, often accompanied by shortness of breath and possibly coughing up blood.
Do Not Miss Diagnoses
- Myocardial Infarction (Heart Attack): One of the most critical diagnoses not to miss, as timely intervention is crucial for survival and minimizing heart damage. The pain is often described as a heavy, squeezing sensation.
- Aortic Dissection: A tear in the aorta's lining can cause severe, tearing chest pain, which is a medical emergency requiring immediate attention.
- Pulmonary Embolism: As mentioned, this condition can be life-threatening and requires prompt diagnosis and treatment.
- Esophageal Rupture: A rare but dangerous condition where the esophagus tears, often requiring emergency surgery.
Rare Diagnoses
- Pericarditis: Inflammation of the sac surrounding the heart can cause sharp chest pain, often improving with leaning forward.
- Pneumothorax: Air in the space between the lungs and chest wall can cause sudden chest pain and shortness of breath.
- Costochondritis (Tietze's Syndrome): Inflammation of the cartilage that connects the ribs to the breastbone can cause chest pain.
- Mitral Valve Prolapse: A condition where the valve between the heart's chambers doesn't close properly, sometimes causing chest pain among other symptoms.