Approach to Chest Pain Differential diagnosis of chest pain

may occur due to some minor illness or may be due to some serous illness, or may be an emergency condition.

 

chest pain

 

Causes of serious chest pain –

• AcuteHyperbilirubinemia Classification Types Symptoms Examination. Read more ... » ischemic heartVETAS SALIX CAPREA Ayurveda Drugs VEDNASTHAPAN DRAVYA work on Nervous System. Read more ... » diseaseHyperbilirubinemia Classification Types Symptoms Examination. Read more ... », or aortic coronary syndrome,
• Aortic dissectionAORTIC DISSECTION Etiology and Clinical manifestations with Treatment. Read more ... »,
• Tension pneumotherix,
• Pulmonary pneumothorex,
• Pulmonary embolism.

The different condition which may cause  chest pain—

Differential diagnosis of chest pain–

Angina—€

• angina pain may last from 2- 10 minutes, the character of pain is heaviness, or tightness, sensation around the chest, it is located in the centre of chest. It may be located in the centre of chest and radiate to the left side of chest, left hand, or both arms, neck ,jaw, shoulder, and back. It is precipitated by exertion, exposure to cold or stress.

On examinationHow to take good medical history & examination. Read more ... » S4 or MR [ mitral regurgitation ]may be found positive.

Unstable angina—

• the pain lasts for 10- 20 minutes, and it may be more serious some time life threatening, may be more serious and precipitated by minimum exertion, or may be at rest, not relived by rest and nitro-glycerine.

Acute myocardial infarctionAcute Myocardial Infarction (AMI) Causes PATHOPHYSIOLOGY and Etiology. Read more ... » 

• —the pain is similar to angina pain, but last for 30 minute and more, and not relived by nitro-glycerine or rest. The more serious complications are like heart failureHeart Failure Treatment Heart Failure GENERAL PRINCIPLES. Read more ... » and erythematic.

Aortic stenosisAortic Stenosis Symptoms Aortic Stenosis Physical Findings Auscultation TREATMENT. Read more ... »— 

• there is characteristic angina pain with ejection systolic systolic murmur radiating to carotids.

PericarditisCOMPLICATIONS OF Acute Myocardial Infarction (AMI) AND TREATMENT -2. Read more ... » 

• —there is retrosternal pain which may be relived by sitting up and leaning forward, a pericardial friction rub heard on auscultationHow to take good medical history & examination. Read more ... » of pericardium.

Aortic dissection

• —there is acute sevear pain which is sharp and stabbed knife like felt in the front of chest and radiate to the back. There is the history of chronic hypertensionHyperthyroidism or THYROTOXICOSIS Causes, Symptoms and Diagnosis. Read more ... », AR, pericardial rub, cardiacVETAS SALIX CAPREA Ayurveda Drugs VEDNASTHAPAN DRAVYA work on Nervous System. Read more ... » temponad, absent peripheral pulses.

Pulmonary hypertension

•  —there is pressureChronic Long-term Complications Of Diabetes Mellitus. Read more ... » pain with dyspnoea, coughInfluenza SARS and Whooping Cough Signs and Symptoms with Diagnosis and Treatment. Read more ... », oedema and raised JVPExamination of arterial pressure pulse with Jugular Venous Pulse (JVP). Read more ... ».

Pneumonia or pleuritis—

• there is pleuritic pain increasing on deep inspiration, may be unilateral, or with dyspnoea, cough, feverThyrotoxic crisis or Thyroid storm. Read more ... », and plural rub.

Pulmonary embolism

 

• —there is acute sevear chest pain, lasting for few minutes to hours with dyspnoea, tachycardiaHyperglycemic Hyperosmolar State (HHS) Acute Complication Of DM. Read more ... », and hypotensionHyperglycemic Hyperosmolar State (HHS) Acute Complication Of DM. Read more ... ».

Spontaneous pneumothorex

 

• —there is sudden onset of sevear chest pain with pleuritic quality, unilateral with syspnea and decreased breath sound on the same side.

Esophageal reflux

 

• —there is burning substernal or epigestric pain lasting for more then an hour and increase on lying down.

Esophageal spasm

 

• —resembles angina pain but last for upto 30 minuts with history of hyper acidityHYPER ACIDITY Caused by H.pylori Gram-Negative diagnosis Treatment Signs and symptoms. Read more ... ».

Peptic ulcers

 

• —there is prolong burning epigestric pain, relived with food intake, or antacid.

Gall bladder disease

 

• —there is burning pain in epigestrium or right hypo chondrium following a meal.

Musculoskeletal disease

 

• —there is aching pain, fatigueFatigue diagnosis medicine and treatment. Read more ... », aggravated by movement often with tenderness.

Herpese joster

• —there is sharp or burning pain in dermatome distribution with v
  esicular rashes.

Assessment of chest pain—

• ECGVETAS SALIX CAPREA Ayurveda Drugs VEDNASTHAPAN DRAVYA work on Nervous System. Read more ... » changes are useful to rule out the ischemic changes of heart disease.
• History of hyper acidity and peptic ulcer suggest acid peptic disease.
• Valvuler heart disease often give rise to pulmonary hypertension and chest pain.
• CausesHyperbilirubinemia Classification Types Symptoms Examination. Read more ... » of pericarditis if present, will be evident.
• Rashes of herpes zpster are clearly seen.
• Cervical spondilitis, arthritis, costo chondritis, and other musculoskeletal disorder give rise to chest pain, and stiffness during movement.
• X-rar, ECG, MRI, CT scan, angiographyCoronary Angiography -Indications of Coronary Arteriography (Angiography). Read more ... », echocardiography2D Echocardiography Dobutamine Stress Echocardiography. Read more ... », ultrasound, serum cardiac markersCARDIAC MARKERS IN MI, AMI and Myocardial Injury. Read more ... », etc, aid diagnosisHyperbilirubinemia Classification Types Symptoms Examination. Read more ... ».

This is brief introduction about chest pain.