Chest pain DDx

Overview

The approach to non-traumatic chest pain requires the early recognition and exclusion of potential life threats, then further consideration of other causes.

Causes

Potentially life-threatening causes of chest pain

Cardiovascular

  • Acute coronary syndromes (STE-ACS and NSTE-ACS)
  • Aortic dissection
  • Myocarditis (most common cause of sudden death in the young)
  • Pericarditis
  • Pulmonary embolism

Other

Common non-life-threatening causes of chest pain

Gastrointestinal

  • Biliary colic
  • Gastroesophageal reflux
  • Peptic ulcer disease

Pulmonary

  • Pneumonia
  • Pleurisy

Chest wall syndromes

  • Musculoskeletal pain
  • Costochondritis
  • Thoracic radiculopathy
  • Bornholm disease (Acute, transient viral myositis associated with Coxsackie B)
  • Tietze syndrome (Idiopathic benign inflammation of one or more of the costal cartilages)
  • Texidor twinge (precordial catch syndrome)
  • Mondor disease

Psychiatric

  • Anxiety
  • Somatisation
  • Da Costa syndrome (Symptom-complex characterized by palpitation, dyspnea, precordial pain, fatigue, exaggerated emotional responses with increased cardiac awareness)

Occult trauma

  • rib fractures

Infection

  • Shingles

CCC 700 6

Critical Care

Compendium

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