Chest pain causes

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Kiran Singh, M.D. [2]

Overview

There are many organ systems, that when affected, can lead to the symptoms of chest pain. The most common organs involved are the heart, lungs, and the digestive system. Psychiatric disorders, can also lead to the perception of chest pain. The most important facet of diagnosis is distinguishing the life-threatening causes of chest pain, to the more benign causes.

Causes

Life Threatening Causes

Common Causes

Heartburn or indigestion
Angina
Chest wall pain, or costochondritis
Myocardial infarction
Esophageal spasm
Aortic dissection
Biliary colic or other gallbladder disease
Anxiety or panic attacks

Causes by Organ System

Cardiovascular	•Accelerated hypertension • acute aortic dissection • acute coronary syndrome • air embolism • aortic aneurysm •aortic coarctation aortic Stenosis • arryhthmias atheroma• atrial fibrillation • atrial flutter • atrial myxoma • Bernheim syndrome • Bland-White-Garland Syndrome • cardiac syndrome X • cardiomyopathy •chronic stable angina • cor pulmonale • coronary artery dissection • coronary heart disease • cytarabine, mitral valve prolapse dilated cardiomyopathy Dressler's syndrome (postpericardiotomy) • eisenmenger syndrome •Familial hypercholesterolemia Heart attack Heller-dohle disease •hypertrophic cardiomyopathy ischemic heart disease • Kawasaki disease • left ventricular hypertrophy • myocardial infarction • myocarditis • nabilone pericardial tamponade •non ST elevation MI • pericarditis • prinzmetal angina • pulmonary embolism • pulmonary infarction • ST elevation MI • stress cardiomyopathy • Takotsubos cardiomyopathy • unstable angina • Wegner's granulomatosis
Chemical / poisoning	• Carbon monoxide • lead • Arsenic dioxide • arsenicals • 1,1-Dimethyl hydrazine • 1,2-Dibromo-3-chloropropane • acetonitrile • acrylonitrile •
Dermatologic	Herpes zoster • SAPHO syndrome •
Drug Side Effect	adenosine • amonafide • amphetamine • aztreonam * bedaquiline fumarate * cidofovir * clomifene • corticorelin * desmopressin • cytosine arabinoside syndrome • dimercaprol • disulfiram • dornase Alfa* dolasetron mesylate febuxostat • gemeprost • glatiramer acetate • idarubicin hydrochloride Indomethacin • Interferon gamma * Iodixanol * Ivacaftor * Fesoterodine • Latanoprost • Levalbuterol • megestrol * naratriptan • Meropenem • methacholine • nylidrin • Oprelvekin * porfimer • phenylephrine • ramucirumab* regadenoson • repaglinide •repaglinide and metformin hydrochloride • rifaximin • rizatriptan • sargramostim * sertraline • sumatriptan • taliglucerase alfa* thalidomide • tamsulosin • tiagabine * tolmetin * topiramate • travoprost • triazolam • trospium * zolmitriptan • zonisamide
Ear Nose Throat	• Retropharyngeal abscess •
Endocrine	•Acromegaly •gynecomastia *hyperthyroidism • hypothyroidism
Environmental	No underlying causes •
Gastroenterologic	• Achalasia • Abdominal distension • Barret’s esophagus • Carcinoma • Cholecystitis •cholelithiasis • Diverticulitis • Duodenitis • Esophageal rupture • esophageal spasm • Esophagitis •Foreign body •Gallbladder disease Gas Gastritis • Gastroesophageal reflux (GERD) • Hiatus Hernia • impacted stone • liver abscess • Mallory-Weiss Syndrome • neoplasm • Nutcracker's esophagus • pancreatitis •peptic ulcer disease • perforated ulcer • Plummer-Vinson Syndrome • pneumoperitoneum • Splenic enlargement • Splenic infarction • Subdiaphragmatic abcsess • Subphrenic abscess • Whipple's Disease • Rumination disorder • Esophageal cyst • Bergman syndrome •
Genetic	• Glycogenosis • Recurrent hereditary polyserositis • Familial mediterranean fever •Familial hypercholesterolemia *Fabry disease
Hematologic	Sickle cell anemia • acute intermittent porphyria • lymphangiomyomatosis • autoimmune hemolytic anemia • Langerhans' cell histiocytosis •
Iatrogenic	• Blood transfusion complication • Cardiopulmonary resuscitation •
Infectious Disease	• Bornholm disease • hepatitis • HIV infection • herpes zoster • actinomyces • alveolar hydatid disease • Subdiaphragmatic abcsess • trichinella spiralis • ankylostomiasis • chagas disease • pneumonia • cryptococcosis • histoplasmosis • Legionnaires' disease • lassa fever •
Musculoskeletal / Ortho	• Bechterew's Disease • Bone tumor • Chondritis Chest wall pain syndrome • Costochondritis • Chosto condral tendinitis • Chosto sternal tendinitis •Connective tissue disease Tietze's syndrome • CS/TS osteochondrosis • Fibromyalgia • Fractured rib •Intercostal muscle spasm • Interstitial fibrosis • Intercostal neuralgia • Muscle strain or spasm • Myofascial pain •Myostitis • Neuritis • Radiculitis • Periostitis • Precordial catch syndrome • Shoulder bursitis •Shoulder tendinitis • Soft tissue sarcoma or tumor • Sternoclavicular arthritis • Strain of pectoralis muscle • Thoracic Outlet Syndrome • Trauma • Vertebrogenic thoracic pain • SAPHO syndrome • Rib pain • Ankylosing spondylitis •
Neurologic	• Tabes dorsalis • Acute spinal cord injury • Shingles • migraine headache
Nutritional / Metabolic	• Respiratory alkalosis • Glycogenosis • Fabry disease •
Oncologic	• Liver cancer • Mesothelioma • Metastatic tumor • Neurofibroma • Pheochromocytoma • Pleural fibroma • Mesothelioma •
Opthalmologic	No underlying causes •
Overdose / Toxicity	• Drugs to treat migraine headache • Amonafide • Amphetamine • Adenosine • Glatiramer acetate • Gemeprost • Naratriptan • Nylidrin • Porfimer • Regadenoson • Rizatriptan • Sumatriptan • Zolmitriptan • Cytosine arabinoside syndrome •
Psychiatric	• Anxiety disorders • Affective disorders (e.g., depression) • Da costa's syndrome • Thought disorders (e.g., fixed delusions) • Hyperventilation syndrome • Hypochondria • Factitious disorders (e.g. Münchausen syndrome • Fabricated or induced illness • Hospital addiction syndrome • Panic attack •Somatoform disorders • Somatization disorder • Functional disorders • Chronic fatigue syndrome • Da Costa's syndrome •
Pulmonary	• Alveolar hydatid disease • Anthracosis • Asbestosis • Asthma • Bronchial carcinoma • Bronchiectasis •Bronchitis Bronchogenic carcinoma • Bronchogenic cyst • carcinomatous • Chronic Obstructive Pulmonary Disease (COPD) • Chronic cough Empyema • Foreign body aspiration • Goodpasture's syndrome • Hemothorax •hyperventilation Interstitial lung disease • Laryngotracheitis • Legionnaires' disease • Lung Abscess • Lung Cancer • Lymphoma • Mediastinitis • Mesothelioma • Pleural Effusion Pleural empyema *Pleural fibroma • Pleuritis • Pleurodynia • Pneumoconiosis • Pneumomediastinum • Pneumonia • Pneumothorax • Pulmonary Embolism • Pulmonary Infarction • Respiratory alkalosis • Silicosis • Tension pneumothorax • Thymoma • Tracheitis • Tracheoesophageal abscess • Tuberculosis
Renal / Electrolyte	• Goodpasture's syndrome •
Rheum / Immune / Allergy	•Chondritis Costochondritis Connective tissue disease *Familial mediterranean fever • Recurrent hereditary polyserositis • Atopy • Autoimmune hemolytic anemia •
Substance abuse	Cocaine •
Trauma	Chest wall injuries • Acute spinal cord injury • Barotrauma •
Miscellaneous	• Collagen vascular disease with pleuritis • Conn's Syndrome •Chinese restaurant syndrome *Degenerative changes of cervical spine •Peritonitis • Pott's Disease • Xiphodynia • Mastalgia • Barotrauma • Decompression sickness •

Causes in Alphabetical Order

3

References