Chest pain causes

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Overview

Historical Perspective

Classification

Pathophysiology

Causes

Differentiating Chest pain from other Diseases

Epidemiology and Demographics

Risk Factors

Screening

Natural History, Complications and Prognosis

Chest Pain in Pregnancy

Diagnosis

Diagnostic Study of Choice

History and Symptoms

Physical Examination

Laboratory Findings

Electrocardiogram

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Echocardiography and Ultrasound

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Treatment

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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

Life-threatening causes include conditions which may result in death or permanent disability within 24 hours if left untreated.

Common Causes

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, Eisenmenger syndrome, familial hypercholesterolemia, heart attack, Heller-dohle disease, hypertrophic cardiomyopathy, ischemic heart disease, isolated coronary artery anomalies, 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 dimethyl hydrazine|1,1-Dimethyl hydrazine, 1,2-Dibromo-3-chloropropane, acetonitrile, acrylonitrile, arsenic dioxide, arsenicals, carbon monoxide, lead
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 Abdominal distension, achalasia, Barret’s esophagus, Bergman syndrome, carcinoma, cholecystitis, cholelithiasis, diverticulitisduodenitis, esophageal cyst, esophageal rupture, esophageal spasm, esophagitis, foreign body, gallbladder disease, gas, gastritis,gastroesophageal reflux (GERD), hiatus Hernia, impacted stone, irritable bowel disease, liver abscess, Mallory-Weiss Syndrome, neoplasm,Nutcracker's esophagus, pancreatitis, peptic ulcer disease, perforated ulcer, Plummer-Vinson Syndrome, pneumoperitoneum rumination disorder, Splenic enlargement, Splenic infarction, Subdiaphragmatic abcsess, Subphrenic abscess, Whipple's Disease
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 spiralisankylostomiasischagas diseasepneumoniacryptococcosishistoplasmosisLegionnaires' diseaselassa fever, mycoplasma pneumonia
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, Fibromyalgia, Fractured rib, Intercostal muscle spasm, Interstitial fibrosis • Intercostal neuralgiaMuscle strain or spasmMusculoskeletal pain *Myofascial pain •MyostitisNeuritisRadiculitisPeriostitisPrecordial catch syndromeShoulder bursitisShoulder tendinitisSoft tissue sarcoma or tumor • Sternoclavicular arthritis • Strain of pectoralis muscle • Thoracic Outlet SyndromeTrauma • Vertebrogenic thoracic pain • SAPHO syndrome • Rib pain • Ankylosing spondylitis
Neurologic Tabes dorsalisAcute spinal cord injuryShinglesmigraine headache
Nutritional / Metabolic Respiratory alkalosisGlycogenosisFabry disease
Oncologic Liver cancermediastinal tumor *mesotheliomametastatic tumorneurofibromapheochromocytoma • Pleural fibroma • mesothelioma
Opthalmologic No underlying causes •
Overdose / Toxicity • Drugs to treat migraine headacheAmonafideAmphetamineAdenosineGlatiramer acetateGemeprostNaratriptan • Nylidrin • Porfimer • RegadenosonRizatriptanSumatriptanZolmitriptan • Cytosine arabinoside syndrome •
Psychiatric Anxiety disordersAffective disorders (e.g., depression) • Da costa's syndrome • Thought disorders (e.g., fixed delusions) • Hyperventilation syndromeHypochondriaFactitious disorders (e.g. Münchausen syndromeFabricated or induced illness • Hospital addiction syndrome • Panic attackSomatoform disordersSomatization disorderFunctional disordersChronic fatigue syndromeDa Costa's syndrome
Pulmonary Alveolar hydatid diseaseAnthracosisAsbestosisAsthmaBronchial carcinomaBronchiectasisBronchitis *Bronchogenic carcinomaBronchogenic cystcarcinomatousChronic Obstructive Pulmonary Disease (COPD) • Chronic cough *EmpyemaForeign body aspirationGoodpasture's syndromeHemothoraxhyperventilation *Interstitial lung diseaseLaryngotracheitisLegionnaires' diseaseLung AbscessLung CancerLymphomaMediastinitisMesotheliomamycoplasma pneumonia Pleural Effusion *Pleural empyema *Pleural fibroma • PleuritisPleurodyniaPneumoconiosisPneumomediastinumPneumoniaPneumothoraxPulmonary EmbolismPulmonary InfarctionRespiratory alkalosisSilicosisTension pneumothoraxThymomaTracheitis • Tracheoesophageal abscess • Tuberculosis
Renal / Electrolyte Goodpasture's syndrome
Rheum / Immune / Allergy Chondritis *Costochondritis *Connective tissue disease *Familial mediterranean feverRecurrent hereditary polyserositisAtopyAutoimmune hemolytic anemia
Substance abuse Cocaine
Trauma Chest wall injuries • Acute spinal cord injuryBarotrauma
Miscellaneous • Collagen vascular disease with pleuritis • Conn's SyndromeChinese restaurant syndrome *Degenerative changes of cervical spine •Idiopathic *PeritonitisMondor's disease *Pott's DiseaseXiphodyniaMastalgiaBarotraumaDecompression sickness

Causes in Alphabetical Order

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References