Chest pain

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DDx

Don’t miss

  • Myocardial ischemia, pericarditis, aortic dissection, pulmonary embolism, tension pneumothorax, esophageal rupture
Cardiovascular
  • Myocardial ischemia (angina, myocardial infarction), pericarditis, aortic stenosis, aortic dissection, pulmonary embolism, cardiomyopathy, myocarditis, mitral valve prolapse, pulmonary hypertension, hypertrophic obstructive cardiomyopathy (HOCM), carditis (eg, acute rheumatic fever), aortic insufficiency, right ventricular hypertrophy
Pulmonary
  • Pneumonia, pleuritis, bronchitis, pneumothorax, tumor
Gastrointestinal
  • Esophageal rupture, gastroesophageal reflux disease (GERD), esophageal spasm, Mallory-Weiss syndrome, peptic ulcer disease, biliary disease, pancreatitis, functional gastrointestinal pain
Musculoskeletal
  • Cervical or thoracic disk disease or arthritis, shoulder arthritis, costochondritis (anterior chest wall syndrome or Tietze’s syndrome), subacromial bursitis
Other
  • Anxiety or panic attack, herpes zoster, breast disorders, chest wall tumors, thoracic outlet syndrome, mediastinitis

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DDx

Don’t miss

  • Myocardial ischemia, pericarditis, aortic dissection, pulmonary embolism, tension pneumothorax, esophageal rupture
Cardiovascular
  • Myocardial ischemia (angina, myocardial infarction), pericarditis, aortic stenosis, aortic dissection, pulmonary embolism, cardiomyopathy, myocarditis, mitral valve prolapse, pulmonary hypertension, hypertrophic obstructive cardiomyopathy (HOCM), carditis (eg, acute rheumatic fever), aortic insufficiency, right ventricular hypertrophy
Pulmonary
  • Pneumonia, pleuritis, bronchitis, pneumothorax, tumor
Gastrointestinal
  • Esophageal rupture, gastroesophageal reflux disease (GERD), esophageal spasm, Mallory-Weiss syndrome, peptic ulcer disease, biliary disease, pancreatitis, functional gastrointestinal pain
Musculoskeletal
  • Cervical or thoracic disk disease or arthritis, shoulder arthritis, costochondritis (anterior chest wall syndrome or Tietze’s syndrome), subacromial bursitis
Other
  • Anxiety or panic attack, herpes zoster, breast disorders, chest wall tumors, thoracic outlet syndrome, mediastinitis

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