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Chest pain differentials

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Simon Daley

Chest pain differentials grouped into body systems & by clinical urgency.

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Presenting complaint; "chest pain". Multiple pathologies to be considered (>50% of ED presentations w/ CP are non-cardiac); Cardiovascular Acute myocardial infarction Aortic dissection Pulmonary embolism Cardiac tamponade Myocardial / valvular rupture Cardiac contusion Tachyarrhythmia / bradyarrhythmia Valvular heart disease Unstable angina Myocarditis / pericarditis Endocarditis Coronary vasospasm Stable angina Cardiomyopathy Hypertension Chronotropic incompetence Life-threatening Urgent Non-urgent Respiratory Tension pneumothorax Acute asthmatic attack Pneumonia Pneumo / haemo / pyo / hydro -thorax Exacerbation of asthma or COPD Pulmonary hypertension Tuberculosis Viral pleurisy Gastrointestinal & Abdominal Ruptured abdominal aortic aneurysm Oesophageal rupture Pancreatitis Cholecystitis / biliary colic Oesophageal reflux / oesophagitis Peptic ulcer Musculoskeletal Septic arthritis / uncomplicated arthritis Costochondritis / chest wall injury Rib / sternal fracture Osteomyolitis Cervical angina Other Mediastinitis Malignancy Fibromyalgia Psychological/Anxiety Hyperventilation Precordial catch syndrome Lupus Post-herpetic neuralgia Herpes zoster SimonMarkDaley(2019) Inspiredbystrata5.co.uk

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Chest pain differentials

  • 1. Presenting complaint; "chest pain". Multiple pathologies to be considered (>50% of ED presentations w/ CP are non-cardiac); Cardiovascular Acute myocardial infarction Aortic dissection Pulmonary embolism Cardiac tamponade Myocardial / valvular rupture Cardiac contusion Tachyarrhythmia / bradyarrhythmia Valvular heart disease Unstable angina Myocarditis / pericarditis Endocarditis Coronary vasospasm Stable angina Cardiomyopathy Hypertension Chronotropic incompetence Life-threatening Urgent Non-urgent Respiratory Tension pneumothorax Acute asthmatic attack Pneumonia Pneumo / haemo / pyo / hydro -thorax Exacerbation of asthma or COPD Pulmonary hypertension Tuberculosis Viral pleurisy Gastrointestinal & Abdominal Ruptured abdominal aortic aneurysm Oesophageal rupture Pancreatitis Cholecystitis / biliary colic Oesophageal reflux / oesophagitis Peptic ulcer Musculoskeletal Septic arthritis / uncomplicated arthritis Costochondritis / chest wall injury Rib / sternal fracture Osteomyolitis Cervical angina Other Mediastinitis Malignancy Fibromyalgia Psychological/Anxiety Hyperventilation Precordial catch syndrome Lupus Post-herpetic neuralgia Herpes zoster SimonMarkDaley(2019) Inspiredbystrata5.co.uk