Suspected causes of Chest Pain
Skin and subcutaneous lesions [including adiposis dolorosa, thrombophlebitis of thoracoepigastric vein (Mondor disease)]
Breast lesions
- Fibroadenosis
- Chronic cystic mastitis
- Acute breast abscess or mastitis
- Carcinoma
- Trauma and hematoma
Musculoskeletal disorders
- Bruised or fractured rib
- Periostitis
- Periosteal hematoma
- Costochondritis (Tietze syndrome)
- Slipping costal cartilage
- Intercostal muscle “stitch†or cramp
- Intercostal myositis
- Pectoral or other muscular strain
- Shoulder girdle disorders (e.g., subacromial bursitis)
- Cervical disc herniation
- Dorsal spine osteoarthritis
- Thoracic outlet syndrome
- Fibromyalgia
Neuralgia
- Herpes zoster
- Tabes dorsalis
- Neurofibroma
- Neoplasm
Pericardial disease
- Pericarditis
- Neoplasm
- Congenital absence of left pericardium
Mediastinal disease
- Mediastinal emphysema
- Neoplasm
- Mediastinitis
Cardiovascular disease
- Coronary heart diseases
- Acute coronary syndrome
- Acute myocardial infarction
- Angina pectoris
- Aortic valvular disease
- Hypertrophic cardiomyopathy
- Cardiomyopathy
- Mitral valve prolapse
- Acute aortic dissection
- Thoracic aortic aneurysm
- Myocarditis
- Cardiac rupture
- Ruptured sinus of Valsalva aneurysm
Pleural or pulmonary disease
- Pleuritis of any etiology (e.g., pneumothorax)
- Tracheobronchitis
- Pneumonia
- Pulmonary hypertension
- Pulmonary thromboembolism
- Pulmonary artery rupture
- Neoplasm
- Bronchogenic carcinoma
- Metastatic tumor
- Mesothelioma
- Other parenchymal lesions
Gastrointestinal disease
- Esophageal lesions
- Esophagitis
- Esophageal spasm
- Mallory-Weiss syndrome
- Esophageal rupture
- Foreign body
- Carcinoma
- Zenker diverticulum
- Plummer-Vinson syndrome
- Hyperalgesia
Peptic ulcer disease (with or without perforation)
Gastric distention
Gastritis
- Biliary disease
- Acute cholecystitis
- Biliary colic
Distention of the liver
- Pancreatitis
- Subphrenic abscess
- Splenic infarct
- Splenic flexure syndrome
Thyroiditis
Psychogenic causes
- Hyperventilation
- Anxiety-panic disorders
- Depression
- Somatization disorders
References
1. Braunwald E. Examination of the patient. See Bibliography, 5.
2. Simel DL. Approach to the patient: history and physical examination. See Bibliography, 2.