Differential Diagnosis for Typical Chest Pain
- Single most likely diagnosis
- Myocardial Infarction (MI): This is the most likely diagnosis for typical chest pain, which is often described as a squeezing, pressure, or heaviness in the chest that may radiate to the arms, back, neck, jaw, or stomach. The pain is usually constant and can be accompanied by shortness of breath, nausea, and diaphoresis.
- Other Likely diagnoses
- Angina Pectoris: This condition is characterized by chest pain or discomfort due to transient myocardial ischemia, often triggered by exertion or emotional stress and relieved by rest or nitroglycerin.
- Pulmonary Embolism (PE): While not as common as MI, PE can cause sudden onset of chest pain that worsens with deep breathing or coughing, often accompanied by shortness of breath and tachycardia.
- Gastroesophageal Reflux Disease (GERD): GERD can cause chest pain that is often described as burning and may be accompanied by regurgitation and dysphagia.
- Do Not Miss (ddxs that may not be likely, but would be deadly if missed.)
- Aortic Dissection: A life-threatening condition where there is a tear in the aorta's inner layer, causing severe, tearing chest pain that radiates to the back.
- Esophageal Rupture: A rare but potentially fatal condition where the esophagus tears, often due to forceful vomiting, causing severe chest pain and difficulty swallowing.
- Pneumothorax: A collapsed lung can cause sudden onset of sharp chest pain and shortness of breath, which can be life-threatening if not promptly treated.
- Rare diagnoses
- Pericarditis: Inflammation of the pericardium, the sac surrounding the heart, can cause sharp, stabbing chest pain that may improve with leaning forward.
- Costochondritis: Inflammation of the cartilage that connects the ribs to the breastbone can cause sharp pains in the chest wall.
- Spontaneous Coronary Artery Dissection (SCAD): A rare condition where there is a tear in the coronary artery, often causing sudden onset of chest pain and potentially leading to MI.