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Differential Diagnosis of Chest Pain

In this article, we will discuss the Differential Diagnosis of Chest Pain. So, let’s get started.

Differential Diagnosis

Cardiac chest pain may radiate to other sites:

  • Mandible (left side of jaw)
  • Chin
  • Left Shoulder
  • Retrosternal radiating to the left arm (common site of origin and radiation)
  • Epigastric region
  • Right arm
  • Interscapular back pain

Based on radiation to these sites following are the differential diagnosis of chest pain:

Retrosternal

  • Myocardial ischemia
  • Esophageal pain
  • Pericarditis
  • Aortic dissection
  • Mediastinitis
  • Pulmonary embolus

Interscapular

  • Myocardial ischemia
  • Musculoskeletal Pain
  • Gallbladder or pancreatic pain

Right lower anterior chest

  • Gallbladder disease
  • Hepatic pain (abscess, hepatitis)
  • Subdiaphragmatic disease/abscess
  • Pneumonia/pleurisy
  • Gastric duodenal ulcer
  • Pulmonary embolism
  • Trauma
  • Myalgia

Shoulder pain

  • Myocardial ischemia
  • Pericarditis, Periarthritis
  • Cervical disc disease
  • Myalgic pain
  • Subdiaphragmatic abscess/pleurisy
  • Thoracic outlet syndrome

Arms

  • Myocardial ischemia
  • Cervical/dorsal spinal pain
  • Thoracic outlet syndrome

Left lower anterior chest pain

  • Neuralgia (intercostal)
  • Pulmonary embolism
  • Myalgia
  • Pneumonia/pleurisy
  • Splenic infarct
  • Subdiaphragmatic disease/abscess

Epigastric

  • Myocardial ischemia
  • Esophageal, gastric and duodenal pain
  • Pericarditis
  • Gallbladder, liver and pancreatic disease
  • Diaphragmatic pleurisy
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