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Chest pain

 

  • Differential diagnosis

    Cardiovascular:

    • Acute coronary syndrome
    • Angina
    • Aortic dissection.
    • Arrhythmia
    • Valve disease
    • Acute pericarditis (pleuritic).
    • Cardiac tamponade.
    • Stress (Takotsubo) cardiomyopathy.

    Pleuritic chest pain i.e. pain on inspiration, is a sign of pleural inflammation. Caused by:

    • Pneumonia
    • PE
    • Pneumothorax
    • Pericarditis
    • Viral pleurisy.
    • Lung cancer.
    • Pleural effusion.

    GI:

    • GORD: commonest non-cardiovascular cause.
    • Peptic ulcer disease.
    • Gallstones
    • Pancreatitis

    Other:

    • Musculoskeletal: trauma, costochondritis.
    • Anxiety: panic attack.
    • Functional: chest wall syndrome.
    • Shingles. Pain may come before rash.

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