Differential Diagnosis for Epigastric Pain
Single most likely diagnosis
- Gastroesophageal reflux disease (GERD): The patient's symptoms of epigastric pain lasting 10 minutes without any aggravating or relieving factors, radiation, sweating, dizziness, or palpitations are consistent with GERD, which is a common condition in the elderly population.
Other Likely diagnoses
- Peptic ulcer disease: Although the patient does not have any radiation or aggravating factors, peptic ulcer disease is still a possible diagnosis, especially in a 70-year-old male.
- Functional dyspepsia: This condition is characterized by recurrent or persistent epigastric pain or discomfort, which may be accompanied by other symptoms such as bloating or early satiety.
- Gastritis: Inflammation of the stomach lining can cause epigastric pain, and the patient's age and lack of other symptoms make this a possible diagnosis.
Do Not Miss (ddxs that may not be likely, but would be deadly if missed)
- Myocardial infarction: Although the patient does not have any radiation, sweating, dizziness, or palpitations, myocardial infarction can present atypically in the elderly, and epigastric pain can be a symptom.
- Pancreatitis: Severe epigastric pain can be a symptom of pancreatitis, and the patient's age and lack of other symptoms do not rule out this diagnosis.
- Aortic dissection: This is a rare but life-threatening condition that can cause epigastric pain, and the patient's age and lack of other symptoms do not rule out this diagnosis.
Rare diagnoses
- Gastric cancer: Although rare, gastric cancer can cause epigastric pain, and the patient's age and lack of other symptoms do not rule out this diagnosis.
- Inflammatory bowel disease: Conditions such as Crohn's disease or ulcerative colitis can cause epigastric pain, although they are less common in the elderly population.
- Mesenteric ischemia: This is a rare condition that can cause severe epigastric pain, and the patient's age and lack of other symptoms do not rule out this diagnosis.