Chest Pain - Differential Diagnosis Algorithm

Cardiovascular Causes:

 - Outflow Obstruction

     • Aortic Stenosis

 - Ischemic

     • Myocardial Infarction

     • Stable/Unstable Angina

 - Non-lschemic

     • Aortic Dissection 

     • Dilating Aneurysm

     • Pericarditis

     • Myocarditis

Pulmonary / Mediastinal Causes:

 - Vascular

     • Pulmonary Embolism (chest pain often not present)

     • Pulmonary Hypertension

 - Chest Wall/Pleura

     • Pneumothorax

     • Pleural Effusion

     • Pleuritis/Serositis

 - Parenchymal

     • Pneumonia with pleurisy

     • Tuberculosis

     • Neoplasm

     • Sarcoidosis

Other Causes:

 - Gastrointestinal

     • Gastro-Esophageal Reflux Disease

     • Biliary Disease

     • Peptic Ulcer Disease

     • Pancreatitis

     • Esophageal Spasm

     • Esophageal Perforation

 - Musculoskeletal

     • Costochondritis

     • Muscular Injury

     • Trauma

 - Neurologic/Psychiatric

     • Anxiety/Panic

     • Herpes Simplex Virus/Post-Herpetic Neuralgia

     • Somatoform Disorder

     • Spinal Radiculopathy



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