Differential Diagnosis for Right Posterior Chest Pain with Swallowing
- Single most likely diagnosis
- Esophageal spasm or esophagitis: This is the most likely diagnosis as the pain is triggered by swallowing, which is a common symptom of esophageal disorders. Esophageal spasm can cause chest pain that is often described as sharp or stabbing, while esophagitis can cause a burning or dull pain.
- Other Likely diagnoses
- Gastroesophageal reflux disease (GERD): GERD can cause chest pain, especially after eating or swallowing, due to the reflux of stomach acid into the esophagus.
- Musculoskeletal pain: Musculoskeletal pain, such as costochondritis or muscle strain, can cause chest pain that is exacerbated by movement or deep breathing.
- Pneumonia or pleurisy: Inflammation of the lung or pleura can cause chest pain that worsens with deep breathing or coughing, and may be referred to the posterior chest.
- Do Not Miss (ddxs that may not be likely, but would be deadly if missed.)
- Esophageal rupture or perforation: Although rare, esophageal rupture or perforation is a life-threatening condition that requires immediate medical attention. Symptoms may include severe chest pain, difficulty swallowing, and vomiting.
- Pulmonary embolism: A pulmonary embolism can cause sudden, severe chest pain that worsens with deep breathing or coughing, and may be referred to the posterior chest.
- Aortic dissection: An aortic dissection can cause severe, tearing chest pain that radiates to the back, and may be associated with swallowing difficulties.
- Rare diagnoses
- Esophageal cancer: Although rare, esophageal cancer can cause chest pain, difficulty swallowing, and weight loss.
- Mediastinitis: Inflammation of the mediastinum, which can be caused by infection or other conditions, can cause chest pain, fever, and difficulty swallowing.
- Thoracic spine disorders: Disorders of the thoracic spine, such as herniated discs or spinal stenosis, can cause chest pain that is referred from the spine.