DDx of Chest Pain
This Daily Doodle represents the differential diagnosis of “chest” pain/discomfort which is quite an extensive list of both cardiac and non-cardiac conditions. In the ER, the initial approach to chest pain is to rule out potentially life-threatening causes, the big 5 include: myocardial infarction, pulmonary embolism, aortic dissection, esophageal rupture and tension pneumothorax.
I find that the easiest way to organize the long differential diagnosis list is by dividing them based on systems. Note: the list below is not a complete list!
- Ischemic: MI, angina (stable/unstable)
- Non-Ischemic: pericarditis, cardiac tamponade, aortic dissection
- Pulmonary Embolism
- Pneumothorax, Tension pneumothorax
- Lung malignancy
- Herpes Zoster (Shingles)
- Fractured rib
- Rheumatoid arthritis
- Muscular pathology
- Gastroesophageal reflux disease
- Esophageal spasm
- Peptic ulcer Disease
- Mallory Weiss Tear
- Biliary Disease
- Somatization Disorder
- Panic attack
Here is a doodle of my doodle which helps explain what all the characters are inside the chest.
- James L Meisel, MD, FACP and Daniel Cottrell, MD “Differential diagnosis of chest pain in adults ” Uptodate. 2014 – http://www.uptodate.com/contents/differential-diagnosis-of-chest-pain-in-adults
“Chest Pain” Daily Doodle by Michiko Maruyama