Chest pain causes: Difference between revisions

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{{Chest pain}}
{{Chest pain}}


{{CMG}}
{{CMG}}; {{AE}} {{Aisha}}, {{KS}},{{nuha}}


==Overview==
==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.
Life threatening causes of chest pain include [[myocardial infarction]], [[aortic dissection]], [[pulmonary embolism]], [[tension pneumothorax]], and [[esophageal rupture]]. Other common causes of chest pain include [[GERD]], chest wall tenderness, [[achalasia]], [[pneumonia]], and [[anxiety]].


==Causes==
==Causes==


===Common Causes===
===Life Threatening Causes<ref name="pmid27981367">{{cite journal| author=Wächter C, Markus B, Schieffer B| title=[Cardiac causes of chest pain]. | journal=Internist (Berl) | year= 2017 | volume= 58 | issue= 1 | pages= 8-21 | pmid=27981367 | doi=10.1007/s00108-016-0165-0 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=27981367  }}</ref><ref name="HoorwegWillemsen2017">{{cite journal|last1=Hoorweg|first1=Beatrijs BN|last2=Willemsen|first2=Robert TA|last3=Cleef|first3=Lotte E|last4=Boogaerts|first4=Tom|last5=Buntinx|first5=Frank|last6=Glatz|first6=Jan FC|last7=Dinant|first7=Geert Jan|title=Frequency of chest pain in primary care, diagnostic tests performed and final diagnoses|journal=Heart|volume=103|issue=21|year=2017|pages=1727–1732|issn=1355-6037|doi=10.1136/heartjnl-2016-310905}}</ref>===
*[[Heartburn]] or [[indigestion]]
 
*[[Angina]]
*[[Aortic dissection]]<ref name="pmid28871571">{{cite journal| author=Gawinecka J, Schönrath F, von Eckardstein A| title=Acute aortic dissection: pathogenesis, risk factors and diagnosis. | journal=Swiss Med Wkly | year= 2017 | volume= 147 | issue=  | pages= w14489 | pmid=28871571 | doi=10.4414/smw.2017.14489 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=28871571  }}</ref>
*Chest wall pain, or [[costochondritis]]
*[[Esophageal rupture]]
*[[Myocardial infarction]]
*[[Myocardial infarction]]<ref name="pmid28634285">{{cite journal| author=Hoorweg BB, Willemsen RT, Cleef LE, Boogaerts T, Buntinx F, Glatz JF | display-authors=etal| title=Frequency of chest pain in primary care, diagnostic tests performed and final diagnoses. | journal=Heart | year= 2017 | volume= 103 | issue= 21 | pages= 1727-1732 | pmid=28634285 | doi=10.1136/heartjnl-2016-310905 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=28634285  }}</ref>
* [[Esophageal spasm]]
*[[Myocarditis]]
*[[Aortic dissection]]
*[[Pulmonary embolism]]
*[[Biliary colic]] or other gallbladder disease
*[[Tension pneumothorax]]<ref name="pmid25264729">{{cite journal| author=Swierzy M, Helmig M, Ismail M, Rückert J, Walles T, Neudecker J| title=[Pneumothorax]. | journal=Zentralbl Chir | year= 2014 | volume= 139 Suppl 1 | issue=  | pages= S69-86; quiz S87 | pmid=25264729 | doi=10.1055/s-0034-1383029 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=25264729  }}</ref>
*[[Anxiety]] or [[panic attacks]]
 
===Common Causes<ref name="pmid20837193">{{cite journal| author=Lenfant C| title=Chest pain of cardiac and noncardiac origin. | journal=Metabolism | year= 2010 | volume= 59 Suppl 1 | issue=  | pages= S41-6 | pmid=20837193 | doi=10.1016/j.metabol.2010.07.014 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=20837193  }}</ref><ref name="pmid27986981">{{cite journal| author=Jany B| title=[Pulmonary causes of chest pain]. | journal=Internist (Berl) | year= 2017 | volume= 58 | issue= 1 | pages= 22-28 | pmid=27986981 | doi=10.1007/s00108-016-0169-9 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=27986981  }}</ref>===
 
*[[Achalasia]]
*[[Anxiety]]
*[[Costochondritis]]
*[[Depression]]
*[[Gastroesophageal reflux disease]]
*[[Pancreatitis]]
*[[Panic disorder]]
*[[Pericarditis]]
*[[Pneumonia]]
*[[Precordial catch syndrome|Precordial catch]]
*[[Unstable angina]]
*


===Causes by Organ System===
===Causes by Organ System===
{|style="width:80%; height:100px" border="1"
 
|style="height:100px"; style="width:25%" border="1" bgcolor="LightSteelBlue" | '''Cardiovascular'''
{| style="width:80%; height:100px" border="1"
|style="height:100px"; style="width:75%" border="1" bgcolor="Beige" | • [[Aortic Dissection|Acute Aortic Dissection]] • [[Acute Coronary Syndrome]] • ([[unstable angina]]) • ([[non ST elevation MI]]) • ([[ST elevation MI]]) • [[Aortic Aneurysm]] • [[Aortic Stenosis]] • [[Arryhthmias]] • [[Bland-White-Garland Syndrome]] • [[Chronic Stable Angina]] • [[Cor pulmonale]] • [[Coronary Heart Disease]] • [[Dressler's syndrome | Dressler's syndrome (postpericardiotomy)]] • [[Cardiomyopathy]] •[[Cytarabine]], [[Mitral valve prolapse]] • [[STEMI|Myocardial infarction]] • [[Myocarditis]] • [[Nabilone]] * [[tamponade|Pericardial tamponade]] •[[Pericarditis]] • [[Takotsubos cardiomyopathy]] • [[Stress cardiomyopathy]] • [[Accelerated hypertension]] • [[Kawasaki disease]] • [[Air embolism]] • [[Coronary artery dissection]] • [[Ischemic heart disease]] • [[Left ventricular hypertrophy]] • [[Prinzmetal angina]] • [[Pulmonary embolism]] • [[Pulmonary infarction]] • [[Cardiac syndrome X]] • Wegner granulomatosis • [[Atrial fibrillation]] • [[Atrial flutter]] • [[Atrial myxoma]] • Bernheim syndrome • [[Eisenmenger syndrome]] • Heller-dohle disease •
| style="width:25%" bgcolor="LightSteelBlue" ; border="1" |'''Cardiovascular'''
| style="width:75%" bgcolor="Beige" ; border="1" |[[Accelerated hypertension]], [[aortic dissection|acute aortic dissection]], [[acute coronary syndrome]], [[aortic aneurysm]], [[aortic coarctation]], [[aortic Stenosis]], [[arryhthmias]], [[atheroma]], [[atrial fibrillation]], [[atrial flutter]], [[atrial myxoma]], Bergman syndrome, Bernheim syndrome, [[Bland-White-Garland Syndrome]], [[cardiac syndrome X]], [[cardiomyopathy]], [[cardiopulmonary resuscitation]], [[chronic stable angina]], [[cor pulmonale]], [[coronary artery dissection]], [[coronary heart disease]], [[dilated cardiomyopathy]], [[Dressler's syndrome]], [[Eisenmenger syndrome]], [[familial hypercholesterolemia]], [[heart attack]], [[Syphilitic aortitis|Heller-dohle disease]], [[hypertrophic cardiomyopathy]], [[ischemic heart disease]], [[isolated coronary artery anomalies]], [[Kawasaki disease]], [[left ventricular hypertrophy]], [[mitral valve prolapse]], [[STEMI|myocardial infarction]] [[myocarditis]], [[non ST elevation MI]], [[tamponade|pericardial tamponade]], [[pericarditis]], [[prinzmetal angina]], [[pulmonary embolism]], [[ST elevation MI]], [[stress cardiomyopathy]], [[Takotsubos cardiomyopathy]], [[unstable angina]]
|-
|-
|-bgcolor="LightSteelBlue"
| bgcolor="LightSteelBlue" |'''Chemical/Poisoning'''
| '''Chemical / poisoning'''
| bgcolor="Beige" |[[Dimethyl hydrazine|1,1-Dimethyl hydrazine]], [[1,2-Dibromo-3-chloropropane]], [[acetonitrile]], [[acrylonitrile]], [[arsenic|arsenic dioxide]], [[arsenicals]], [[carbon monoxide]], [[lead]]
|bgcolor="Beige"| • [[Carbon monoxide]] • [[Lead]] • Arsenic dioxide • [[Arsenicals]] • 1,1-Dimethyl hydrazine • [[1,2-Dibromo-3-chloropropane]] • [[Acetonitrile]] • [[Acrylonitrile]] •
|-
|-
|-bgcolor="LightSteelBlue"
| bgcolor="LightSteelBlue" |'''Dental'''
| '''Dermatologic'''
| bgcolor="Beige" |No underlying causes
|bgcolor="Beige"| [[Herpes zoster]] • [[SAPHO syndrome]] •
|-
|-
|-bgcolor="LightSteelBlue"
| bgcolor="LightSteelBlue" |'''Dermatologic'''
| '''Drug Side Effect'''
| bgcolor="Beige" |[[Herpes zoster]], [[SAPHO syndrome]]
|bgcolor="Beige"| Drugs to treat • [[Amonafide]] • [[Amphetamine]] • [[Adenosine]] • [[Aztreonam]] * [[bedaquiline fumarate]] * [[Cidofovir]] * [[Clomifene]] • [[Desmopressin]] • [[Dimercaprol]]  •  [[Disulfiram]] • [[Dornase Alfa]]* [[Febuxostat]] • [[Glatiramer acetate]] • [[Gemeprost]] • [[Idarubicin hydrochloride]] * [[Indomethacin]] • [[Interferon gamma]] * [[Ivacaftor]] * [[Fesoterodine]] • [[Latanoprost]] • [[Levalbuterol]] • [[Meropenem]] •  [[Megestrol]] * [[Naratriptan]] • [[Nylidrin]] • [[Porfimer]] • [[Phenylephrine]] • [[Regadenoson]] • [[Repaglinide]] •[[Repaglinide and Metformin hydrochloride]] • [[Rifaximin]] • [[Rizatriptan]] • [[Sertraline]] • [[Sumatriptan]] • [[Tamsulosin]] • [[Thalidomide]] • [[Tiagabine]] * [[Topiramate]] • [[Travoprost]] • [[Triazolam]] • [[Zolmitriptan]] • Cytosine arabinoside syndrome • [[Zonisamide]]
|-
|-
|-bgcolor="LightSteelBlue"
| bgcolor="LightSteelBlue" |'''Drug Side Effect'''
| '''Ear Nose Throat'''
| bgcolor="Beige" |[[Adenosine]], [[amonafide]], [[amphetamine]], [[aztreonam]], [[bedaquiline fumarate]], [[cidofovir]], [[clomifene]], [[corticorelin]], [[cytarabine]], [[cytarabine|cytosine arabinoside syndrome]][[desmopressin]], [[dimercaprol]], [[disulfiram]], [[dolasetron mesylate]], [[dornase Alfa]], [[febuxostat]], [[fesoterodine]], [[gemeprost]], [[glatiramer acetate]], [[idarubicin hydrochloride]], [[indomethacin]], [[interferon gamma]], [[iodixanol]], [[ivacaftor]], [[latanoprost]], [[levalbuterol]], [[megestrol]], [[meropenem]],[[nylidrin]], [[methacholine]], [[nabilone]], [[naratriptan]], [[Oprelvekin]], [[phenylephrine]], [[porfimer]], [[porfimer]],[[regadenoson]], [[ramucirumab]], [[repaglinide]], [[Repaglinide and Metformin hydrochloride|repaglinide and metformin hydrochloride]], [[rifaximin]], [[rizatriptan]], [[sargramostim]], [[sertraline]], [[sumatriptan]], [[taliglucerase alfa]], [[tamsulosin]], [[thalidomide]], [[tiagabine]], [[tolmetin]], [[topiramate]], [[travoprost]], [[triazolam]], [[trospium]], [[zolmitriptan]], [[zonisamide]]
|bgcolor="Beige"| • [[Retropharyngeal abscess]] •
|-
|-bgcolor="LightSteelBlue"
| '''Endocrine'''
|bgcolor="Beige"| • [[Acromegaly]] • [[Hyperthyroidism]] •  [[Hypothyroidism]]
|-
|-bgcolor="LightSteelBlue"
| '''Environmental'''
|bgcolor="Beige"| No underlying causes •
|-
|-
|-bgcolor="LightSteelBlue"
| bgcolor="LightSteelBlue" |'''Ear Nose Throat'''
| '''Gastroenterologic'''
| bgcolor="Beige" |[[Retropharyngeal abscess]]
|bgcolor="Beige"| • [[Achalasia]] • [[Abdominal distension]] • [[Barret’s esophagus]] • [[Carcinoma]] • [[Cholecystitis]] •[[Cholelithiasis]] • [[Diverticulitis]] • [[Duodenitis]] • [[Esophageal rupture]] • [[Esophageal spasm]] • [[Esophagitis]] •[[Foreign body]] • [[Gastritis]] • [[Gastroesophageal reflux]] ([[GERD]]) • [[Hiatus Hernia]] • [[Impacted stone]] • [[Liver abscess]] • [[Mallory-Weiss Syndrome]] • [[Neoplasm]] • [[nutcracker's esophagus|Nutcracker's esophagus]] • [[Pancreatitis]] •[[Peptic ulcer disease]] • [[Perforated ulcer]] • [[Plummer-Vinson Syndrome]] • [[Pneumoperitoneum]] • [[Splenomegaly|Splenic enlargement]] • [[Splenic infarction]] • Subdiaphragmatic abcsess • [[Subphrenic abscess]] • [[Whipple's Disease]] •  [[Rumination disorder]] • [[Esophageal cyst]] • Bergman syndrome •
|-
|-
|-bgcolor="LightSteelBlue"
| bgcolor="LightSteelBlue" |'''Endocrine'''
| '''Genetic'''
| bgcolor="Beige" |[[Acromegaly]], [[conn's Syndrome]], [[gynecomastia]], [[hyperthyroidism]], [[hypothyroidism]]
|bgcolor="Beige"| • [[Glycogenosis]] •  [[Recurrent hereditary polyserositis]] • [[Familial mediterranean fever]] • [[Fabry disease]] •
|-
|-
|-bgcolor="LightSteelBlue"
| bgcolor="LightSteelBlue" |'''Environmental'''
| '''Hematologic'''
| bgcolor="Beige" |No underlying causes
|bgcolor="Beige"| [[Sickle cell anemia]] • [[Acute intermittent porphyria]] • [[Lymphangiomyomatosis]] • [[Autoimmune hemolytic anemia]] • [[Langerhans' cell histiocytosis]] •
|-
|-
|-bgcolor="LightSteelBlue"
| bgcolor="LightSteelBlue" |'''Gastroenterologic'''
| '''Iatrogenic'''
| bgcolor="Beige" |[[Abdominal distension]], [[achalasia]], [[Barret’s esophagus]], Bergman syndrome, [[cholecystitis]], [[cholelithiasis]], [[diverticulitis]], [[duodenitis]], [[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|nutcracker's esophagus]], [[pancreatitis]], [[peptic ulcer disease]], [[perforated ulcer]], [[peritonitis]], [[Plummer-Vinson Syndrome]], [[pneumoperitoneum]] [[rumination disorder]], [[splenomegaly|splenic enlargement]], [[splenic infarction]], [[subdiaphragmatic abcsess]], [[subphrenic abscess]], [[Whipple's Disease]]
|bgcolor="Beige"| • Blood transfusion complication •  [[Cardiopulmonary resuscitation]] •
|-
|-
|-bgcolor="LightSteelBlue"
| bgcolor="LightSteelBlue" |'''Genetic'''
| '''Infectious Disease'''
| bgcolor="Beige" |[[Fabry disease]] , [[familial hypercholesterolemia]], [[familial mediterranean fever]], [[recurrent hereditary polyserositis]]
|bgcolor="Beige"| • [[Bornholm disease]] • [[Hepatitis]] • [[HIV|HIV infection]] • [[Herpes Zoster]] •  [[Actinomyces]] • [[Alveolar hydatid disease]] • Subdiaphragmatic abcsess • [[Trichinella spiralis]] • [[Ankylostomiasis]] • [[Chagas disease]] • [[Pneumonia]] • [[Cryptococcosis]] • [[Histoplasmosis]] • [[Legionnaires' disease]] • [[Lassa fever]] •
|-
|-
|-bgcolor="LightSteelBlue"
| bgcolor="LightSteelBlue" |'''Hematologic'''
| '''Musculoskeletal / Ortho'''
| bgcolor="Beige" |[[Acute intermittent porphyria]], [[autoimmune hemolytic anemia]], [[blood transfusion|blood transfusion complication]], [[langerhans' cell histiocytosis]] , [[lymphangiomyomatosis]], [[pulmonary embolism]],  [[sickle cell anemia]]
|bgcolor="Beige"| • [[Bechterew's Disease]] • [[Bone tumor]] • Chest wall pain syndrome • [[Costochondritis]] • Chosto condral tendinitis • Chosto sternal tendinitis • [[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]] • [[bursitis|Shoulder bursitis]] •[[tendinitis|Shoulder tendinitis]] • [[tumor|Soft tissue sarcoma or tumor]] • Sternoclavicular arthritis • Strain of pectoralis muscle • [[Thoracic Outlet Syndrome]] • [[Trauma]] • Vertebrogenic thoracic pain • [[SAPHO syndrome]] • Rib pain • [[Ankylosing spondylitis]] •
|-
|-
|-bgcolor="LightSteelBlue"
| bgcolor="LightSteelBlue" |'''Iatrogenic'''
| '''Neurologic'''
| bgcolor="Beige" |No underlying causes
|bgcolor="Beige"| • [[Tabes dorsalis]] • [[Acute spinal cord injury]] • [[Shingles]] • [[migraine headache]]
|-
|-
|-bgcolor="LightSteelBlue"
| bgcolor="LightSteelBlue" |'''Infectious Disease'''
| '''Nutritional / Metabolic'''
| bgcolor="Beige" |[[Alveolar hydatid disease]], [[ankylostomiasis]], [[Bornholm disease]], [[chagas disease]], [[cryptococcosis]], [[hepatitis]], [[herpes zoster]], [[Herpes zoster]],[[Actinomyces]], [[histoplasmosis]], [[HIV|HIV infection]], [[lassa fever]], [[Legionnaires' disease]], [[mycoplasma pneumonia]], [[peritonitis]], [[pneumonia]], [[Pott's Disease]], [[Subdiaphragmatic abcsess]], [[trichinella spiralis]]
|bgcolor="Beige"| • [[Respiratory alkalosis]] • [[Glycogenosis]] • [[Fabry disease]] •
|-
|-
|-bgcolor="LightSteelBlue"
| bgcolor="LightSteelBlue" |'''Musculoskeletal/Orthopedic'''
| '''Oncologic'''
| bgcolor="Beige" |[[SAPHO syndrome]], [[Ankylosing spondylitis]] , [[Bechterew's Disease]], [[chest wall pain syndrome]], [[chondritis]], [[tendinitis|costosternal tendinitis]], [[connective tissue disease]], [[chondritis]], [[costochondritis]], [[tendinitis|costochondrol tendinitis]], [[degenerative changes of cervical spine]], [[fibromyalgia]], [[fractured rib]], [[intercostal muscle spasm]], [[intercostal neuralgia]], [[interstitial fibrosis]], [[muscle strain or spasm]], [[musculoskeletal pain ]] , [[myofascial pain syndrome|myofascial pain]], [[myostitis]], [[Pectus excavatum]], [[periostitis]], [[precordial catch syndrome]] [[bursitis|shoulder bursitis]], [[radiculitis]], [[pain|rib pain]], [[SAPHO syndrome]], [[tendinitis|shoulder tendinitis]], [[tumor|Soft tissue sarcoma or tumor]], [[arthritis|sternoclavicular arthritis]], [[strain (injury)|strain of pectoralis muscle]], [[thoracic outlet syndrome]], [[Tietze's syndrome]], [[back pain|vertebrogenic thoracic pain]], [[xiphodynia]]
|bgcolor="Beige"| • [[Liver cancer]] • [[Mesothelioma]] • [[Metastatic tumor]] • [[Neurofibroma]] • [[Pheochromocytoma]] • Pleural fibroma • [[Mesothelioma]] •
|-
|-
|-bgcolor="LightSteelBlue"
| bgcolor="LightSteelBlue" |'''Neurologic'''
| '''Opthalmologic'''
| bgcolor="Beige" |[[Acute spinal cord injury]], [[migraine headache]], [[neuritis]], [[shingles]], [[tabes dorsalis]]
|bgcolor="Beige"| No underlying causes •
|-
|-
|-bgcolor="LightSteelBlue"
| bgcolor="LightSteelBlue" |'''Nutritional/Metabolic'''
| '''Overdose / Toxicity'''
| bgcolor="Beige" |[[Glycogenosis]]
|bgcolor="Beige"| • Drugs to treat [[migraine headache]] • [[Amonafide]] • [[Amphetamine]] • [[Adenosine]] • [[Glatiramer acetate]] • [[Gemeprost]] • [[Naratriptan]] • Nylidrin • Porfimer • [[Regadenoson]] • [[Rizatriptan]] • [[Sumatriptan]] • [[Zolmitriptan]] • Cytosine arabinoside syndrome •
|-
|-
|-bgcolor="LightSteelBlue"
| bgcolor="LightSteelBlue" |'''Obstetric/Gynecologic'''
| '''Psychiatric'''
| bgcolor="Beige" |[[Mastalgia]], [[Mondor's disease]], [[thelarche]]
|bgcolor="Beige"| • [[Anxiety|Anxiety disorders]] • [[Affective disorders]] (e.g., [[depression]]) • [[Da costa's syndrome]] • Thought disorders (e.g., [[delusions|fixed delusions]]) • [[Hyperventilation syndrome]] • [[Hypochondria]] • [[Factitious disorders]] (e.g. [[Münchausen syndrome]] • [[Fabricated or induced illness]] • Hospital addiction syndrome • [[Panic attack]] •[[Somatoform disorder]]s •  [[Somatization disorder]] • [[Functional disorders]] • [[Chronic fatigue syndrome]] • [[Da Costa's syndrome]] •
|-
|-
|-bgcolor="LightSteelBlue"
| bgcolor="LightSteelBlue" |'''Oncologic'''
| '''Pulmonary'''
| bgcolor="Beige" |[[Bone tumor]], [[bronchial carcinoma]], [[bronchogenic carcinoma]], [[liver cancer]], [[langerhans' cell histiocytosis]], [[mediastinal tumor]], [[mesothelioma]], [[metastatic tumor]], [[neurofibroma]], [[pheochromocytoma]], [[pleural fibroma]]
|bgcolor="Beige"| • [[Asthma]] • [[Bronchial carcinoma]] • [[Bronchiectasis]] • [[Bronchogenic carcinoma]] • [[Carcinomatous]] • [[Pleural Effusion]] • [[Chronic Obstructive Pulmonary Disease]] ([[COPD]]) • [[Empyema]] • [[Hemothorax]] • [[Lung Abscess]] • [[Lung Cancer]] • [[Lymphoma]] • [[Mediastinitis]] • [[Pleuritis]] • [[Pleurodynia]] • [[Pneumomediastinum]] • [[Pneumonia]] • [[Pneumothorax]] • [[Pulmonary Embolism]] • [[Pulmonary Infarction]] • [[pneumothorax|Tension pneumothorax]] • [[Thymoma]] • Tracheoesophageal abscess • [[Tuberculosis]] •  [[Silicosis]] • [[Tracheitis]] • [[Alveolar hydatid disease]] • [[Respiratory alkalosis]] • [[Bronchogenic cyst]] • Pleural fibroma • [[Mesothelioma]] • [[Anthracosis]] • [[Asbestosis]] • [[Foreign body aspiration]] • [[Pneumoconiosis]] • [[Laryngotracheitis]] • [[Goodpasture's syndrome]] • [[Interstitial lung disease]] • [[Legionnaires' disease]] •
|-
|-
|-bgcolor="LightSteelBlue"
| bgcolor="LightSteelBlue" |'''Ophthalmologic'''
| '''Renal / Electrolyte'''
| bgcolor="Beige" |No underlying causes
|bgcolor="Beige"| • [[Goodpasture's syndrome]] •
|-
|-
|-bgcolor="LightSteelBlue"
| bgcolor="LightSteelBlue" |'''Overdose/Toxicity'''
| '''Rheum / Immune / Allergy'''
| bgcolor="Beige" |No underlying causes
|bgcolor="Beige"| •[[Familial mediterranean fever]] •  [[Recurrent hereditary polyserositis]] • [[Atopy]] • [[Autoimmune hemolytic anemia]] •
|-
|-
|-bgcolor="LightSteelBlue"
| bgcolor="LightSteelBlue" |'''Psychiatric'''
| '''Substance abuse'''
| bgcolor="Beige" |[[Affective disorders]] (e.g., [[anxiety|anxiety disorders]], [[chronic fatigue syndrome]], [[Da costa's syndrome]], [[depression]]), [[fabricated or induced illness]], [[factitious disorders]] (e.g. [[münchausen syndrome]], [[delusions|fixed delusions]]) [[hyperventilation syndrome]], [[functional disorders]], [[münchausen syndrome|hospital addiction syndrome]], [[hypochondria]], [[panic attack]], [[somatization disorder]], [[somatoform disorder]]s, [[thought disorder]]s
|bgcolor="Beige"| [[Cocaine]] •
|-
|-
|-bgcolor="LightSteelBlue"
| bgcolor="LightSteelBlue" |'''Pulmonary'''
| '''Trauma'''
| bgcolor="Beige" |[[Alveolar hydatid disease]] [[anthracosis]], [[asbestosis]], [[asthma]], [[barotrauma]], [[bronchial carcinoma]], [[bronchiectasis]], [[bronchitis]], [[bronchogenic carcinoma]], [[bronchogenic cyst]], [[cough|chronic cough]], [[chronic obstructive pulmonary disease]] ([[COPD]]), [[cor pulmonale]], [[empyema]], [[foreign body aspiration]] [[Goodpasture's syndrome]], [[hemothorax]], [[hyperventilation]], [[Interstitial lung disease]], [[laryngotracheitis]], [[legionnaires' disease]], [[lung abscess]], [[lung Cancer]], [[lymphoma]], [[mediastinitis]], [[mesothelioma]], [[mycoplasma pneumonia]], [[pleural effusion]], [[pleural empyema]], [[pleural fibroma]], [[pleuritis]],[[pleurodynia]], [[pneumoconiosis]], [[pneumomediastinum]], [[pneumonia]], [[pneumothorax]], [[pulmonary embolism]], [[pulmonary infarction]], [[respiratory alkalosis]],[[silicosis]], [[pneumothorax|tension pneumothorax]], [[thymoma]], [[tracheitis]], [[tracheoesophageal abscess]], [[tuberculosis]],  [[Wegner's Granulomatosis|wegner's granulomatosis]]
|bgcolor="Beige"| Chest wall injuries • [[Acute spinal cord injury]] • [[Barotrauma]] •
|-
|-
|-bgcolor="LightSteelBlue"
| bgcolor="LightSteelBlue" |'''Renal/Electrolyte'''
| '''Miscellaneous'''
| bgcolor="Beige" |[[Goodpasture's syndrome]] , [[Wegner's Granulomatosis|Wegner's granulomatosis]]
|bgcolor="Beige"| • Collagen vascular disease with pleuritis • [[Conn's Syndrome]] • Degenerative changes of cervical spine •[[Peritonitis]] • [[Pott's Disease]] • [[Xiphodynia]] •  [[Mastalgia]] • [[Barotrauma]] • [[Decompression sickness]] •
|-
|-
| bgcolor="LightSteelBlue" |'''Rheumatology/Immunology/Allergy'''
| bgcolor="Beige" |[[Atopy]], [[autoimmune hemolytic anemia]] , [[chondritis]], [[connective tissue disease]], [[costochondritis]], [[degenerative changes of cervical spine]], [[familial mediterranean fever]], [[fibromyalgia]], [[Goodpasture's syndrome]], [[langerhans' cell histiocytosis]], [[recurrent hereditary polyserositis]], [[Wegner's Granulomatosis|Wegner's granulomatosis]]
|-
| bgcolor="LightSteelBlue" |'''Sexual'''
| bgcolor="Beige" |No underlying causes
|-
| bgcolor="LightSteelBlue" |'''Trauma'''
| bgcolor="Beige" |[[Acute spinal cord injury]], [[barotrauma]], chest wall injuries
|-
| bgcolor="LightSteelBlue" |'''Urologic'''
| bgcolor="Beige" |No underlying causes
|-
| bgcolor="LightSteelBlue" |'''Miscellaneous'''
| bgcolor="Beige" |[[Air embolism]],[[Chinese restaurant syndrome]], [[decompression sickness]] , [[Idiopathic]]
|}
|}
===Causes in Alphabetical Order===
{{MultiCol}}
*1,1-Dimethyl hydrazine
*[[1,2-Dibromo-3-chloropropane]]
*[[Abdominal distension]]
*[[Accelerated hypertension]]
*[[Acetonitrile]]
*[[Achalasia]]
*[[Acromegaly]]
*[[Acrylonitrile]]
*[[Actinomyces]]
*[[Aortic Dissection|Acute Aortic Dissection]]
*[[Acute Coronary Syndrome]]
*[[Acute intermittent porphyria]]
*[[Acute spinal cord injury]]
*[[Adenosine]]
*[[Affective disorders]] (e.g., [[depression]])
*[[Air embolism]]
*[[Alveolar hydatid disease]]
*[[Amonafide]]
*[[Amphetamine]]
*[[Ankylosing spondylitis]]
*[[Ankylostomiasis]]
*[[Anthracosis]]
*[[Anxiety|Anxiety disorders]]
*[[Aortic Aneurysm]]
*[[Aortic Stenosis]]
*[[Arryhthmias]]
*Arsenic dioxide
*[[Arsenicals]]
*[[Asbestosis]]
*[[Asthma]]
*[[Atopy]]
*[[Atrial flutter]]
*[[Atrial fibrillation]]
*[[Atrial myxoma]]
*[[Autoimmune hemolytic anemia]]
*[[Aztreonam]]
*[[Barotrauma]]
*[[Barotrauma]]
*[[Barret’s esophagus]]
*[[Bechterew's Disease]]
*Bergman syndrome
*Bernheim syndrome
*[[Bland-White-Garland Syndrome]]
*Blood transfusion complication
*[[Bone tumor]]
*[[Bornholm disease]]
*[[Bronchial carcinoma]]
*[[Bronchiectasis]]
*[[Bronchogenic carcinoma]]
*[[Bronchogenic cyst]]
*[[Carbon monoxide]]
*[[Carcinoma]]
*[[Carcinomatous]]
*[[Cardiac syndrome X]]
*[[Cardiomyopathy]]
*[[Cardiopulmonary resuscitation]]
*[[Chagas disease]]
*Chest wall injuries
*Chest wall pain syndrome
*[[Cholecystitis]]
*[[Cholelithiasis]]
*[[Chronic fatigue syndrome]]
*[[Chronic Obstructive Pulmonary Disease]] ([[COPD]])
*[[Chronic Stable Angina]]
*[[Cidofovir]]
*[[Cocaine]]
*Collagen vascular disease with pleuritis
*[[Conn's Syndrome]]
*[[Cor pulmonale]]
*[[Coronary artery dissection]]
*[[Coronary Heart Disease]]
*[[Costochondritis]]
*Costocondrial tendinitis
*Costosternal tendinitis
*[[Cryptococcosis]]
{{ColBreak}}
*CS/TS osteochondrosis
*Cytosine arabinoside syndrome
*[[Cytarabine]]
*[[Da costa's syndrome]]
*[[Decompression sickness]]
*Degenerative changes of cervical spine
*[[Desmopressin]]
*[[Diverticulitis]]
*[[Dressler's syndrome | Dressler's syndrome (postpericardiotomy)]]
*Drugs to treat migraine headache
*[[Duodenitis]]
*[[Eisenmenger syndrome]]
*[[Empyema]]
*[[Esophageal cyst]]
*[[Esophageal rupture]]
*[[Esophageal spasm]]
*[[Esophagitis]]
*[[Fabricated or induced illness]]
*[[Fabry disease]]
*[[Factitious disorders]] (e.g. [[Münchausen syndrome]])
*[[Familial mediterranean fever]]
*[[Fibromyalgia]]
*[[Foreign body aspiration]]
*[[Foreign body]]
*[[Fractured rib]]
*[[Functional disorders]]
*[[Gastritis]]
*[[Gastroesophageal reflux]] ([[GERD]])
*[[Gemeprost]]
*[[Glatiramer acetate]]
*[[Glycogenosis]]
*[[Goodpasture's syndrome]]
*Heller-Dohle disease
*[[Hemothorax]]
*[[Hepatitis]]
*[[Herpes zoster]]
*[[Hiatus Hernia]]
*[[Histoplasmosis]]
*[[HIV|HIV infection]]
*Hospital addiction syndrome
*[[Hyperthyroidism]]
*[[Hyperventilation syndrome]]
*[[Hypochondria]]
*[[Hypothyroidism]]
*[[Idarubicin hydrochloride]]
*[[Impacted stone]]
*[[Infliximab]]
*[[Intercostal muscle spasm]]
*[[Intercostal neuralgia]]
*[[Interferon gamma]]
*[[Interstitial fibrosis]]
*[[Interstitial lung disease]]
*[[Ischemic heart disease]]
*[[Ivacaftor]]
*[[Kawasaki disease]]
*[[Langerhans' cell histiocytosis]]
*[[Laryngotracheitis]]
*[[Lassa fever]]
*[[Lead]]
*[[Left ventricular hypertrophy]]
*[[Legionnaires' disease]]
*[[Liver abscess]]
*[[Liver cancer]]
*[[Lung Abscess]]
*[[Lung Cancer]]
*[[Lymphangiomyomatosis]]
*[[Lymphoma]]
*[[Mallory-Weiss Syndrome]]
*[[Mastalgia]]
*[[Mediastinitis]]
*[[Mesothelioma]]
*[[Mesothelioma]]
*[[Metastatic tumor]]
*[[Mitral valve prolapse]]
*[[Muscle strain or spasm]]
*[[Myocarditis]]
*Myofascial pain
*[[Myostitis]]
*[[Naratriptan]]
*[[Nabilone]]
*[[Neoplasm]]
{{ColBreak}}
*[[Neuritis]]
*[[Neurofibroma]]
*[[non ST elevation MI]]
*[[nutcracker's esophagus|Nutcracker's esophagus]]
*Nylidrin
*[[Pancreatitis]]
*[[Panic attack]]
*[[Peptic ulcer disease]]
*[[Perforated ulcer]]
*[[tamponade|Pericardial tamponade]]
*[[Pericarditis]]
*[[Periostitis]]
*[[Peritonitis]]
*[[Pheochromocytoma]]
*[[Pleural Effusion]]
*Pleural fibroma
*[[Pleuritis]]
*[[Pleurodynia]]
*[[Plummer-Vinson Syndrome]]
*[[Pneumoconiosis]]
*[[Pneumomediastinum]]
*[[Pneumonia]]
*[[Pneumoperitoneum]]
*[[Pneumothorax]]
*Porfimer
*[[Pott's Disease]]
*[[Precordial catch syndrome]]
*[[Prinzmetal angina]]
*[[Pulmonary embolism]]
*[[Pulmonary infarction]]
*[[Radiculitis]]
*[[Recurrent hereditary polyserositis]]
*[[Regadenoson]]
*[[Respiratory alkalosis]]
*[[Retropharyngeal abscess]]
*Rib pain
*[[Rizatriptan]]
*[[Rumination disorder]]
*[[SAPHO syndrome]]
*[[Shingles]]
*[[bursitis|Shoulder bursitis]]
*[[tendinitis|Shoulder tendinitis]]
*[[Sickle cell anemia]]
*[[Silicosis]]
*[[Somatization disorder]]
*[[Somatoform disorder]]s
*[[Splenomegaly|Splenic enlargement]]
*[[Splenic infarction]]
*[[ST elevation MI]]
*[[STEMI|Myocardial infarction]]
*Sternoclavicular arthritis
*Strain of pectoralis muscle
*[[Stress cardiomyopathy]]
*Subdiaphragmatic abcsess
*[[Subphrenic abscess]]
*[[Sumatriptan]]
*[[Tabes dorsalis]]
*[[Takotsubos cardiomyopathy]]
*[[pneumothorax|Tension pneumothorax]]
*[[Thoracic Outlet Syndrome]]
*Thought disorders (e.g., fixed delusions)
*[[Thymoma]]
*[[Tiagabine]]
*[[Tietze's syndrome]]
*[[Tracheitis]]
*Tracheoesophageal abscess
*[[Trauma]]
*[[Trichinella spiralis]]
*[[Tuberculosis]]
*[[tumor|Soft tissue sarcoma or tumor]]
*[[unstable angina]]
*Vertebrogenic thoracic pain
*Wegner granulomatosis
*[[Whipple's Disease]]
*[[Xiphodynia]]
*[[Zolmitriptan]]
{{EndMultiCol}}


==References==
==References==
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[[Category:Cardiology]]
[[Category:Cardiology]]
[[Category:Crowdiagnosis]]
[[Category:Pulmonology]]
[[Category:Pulmonology]]
[[Category:Signs and symptoms]]
[[Category:Emergency medicine]]
[[Category:Emergency medicine]]
[[Category:Gastroenterology]]
[[Category:Gastroenterology]]
[[Category:Mature chapter]]
[[Category:Up-To-Date]]
[[Category:Up-To-Date cardiology]]

Latest revision as of 18:14, 15 December 2021

Chest pain Microchapters

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Aisha Adigun, B.Sc., M.D.[2], Kiran Singh, M.D. [3],Nuha Al-Howthi, MD[4]

Overview

Life threatening causes of chest pain include myocardial infarction, aortic dissection, pulmonary embolism, tension pneumothorax, and esophageal rupture. Other common causes of chest pain include GERD, chest wall tenderness, achalasia, pneumonia, and anxiety.

Causes

Life Threatening Causes[1][2]

Common Causes[6][7]

Causes by Organ System

Cardiovascular Accelerated hypertension, acute aortic dissection, acute coronary syndrome, aortic aneurysm, aortic coarctation, aortic Stenosis, arryhthmias, atheroma, atrial fibrillation, atrial flutter, atrial myxoma, Bergman syndrome, Bernheim syndrome, Bland-White-Garland Syndrome, cardiac syndrome X, cardiomyopathy, cardiopulmonary resuscitation, chronic stable angina, cor pulmonale, coronary artery dissection, coronary heart disease, 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, mitral valve prolapse, myocardial infarction myocarditis, non ST elevation MI, pericardial tamponade, pericarditis, prinzmetal angina, pulmonary embolism, ST elevation MI, stress cardiomyopathy, Takotsubos cardiomyopathy, unstable angina
Chemical/Poisoning 1,1-Dimethyl hydrazine, 1,2-Dibromo-3-chloropropane, acetonitrile, acrylonitrile, arsenic dioxide, arsenicals, carbon monoxide, lead
Dental No underlying causes
Dermatologic Herpes zoster, SAPHO syndrome
Drug Side Effect Adenosine, amonafide, amphetamine, aztreonam, bedaquiline fumarate, cidofovir, clomifene, corticorelin, cytarabine, cytosine arabinoside syndromedesmopressin, dimercaprol, disulfiram, dolasetron mesylate, dornase Alfa, febuxostat, fesoterodine, gemeprost, glatiramer acetate, idarubicin hydrochloride, indomethacin, interferon gamma, iodixanol, ivacaftor, latanoprost, levalbuterol, megestrol, meropenem,nylidrin, methacholine, nabilone, naratriptan, Oprelvekin, phenylephrine, porfimer, porfimer,regadenoson, ramucirumab, repaglinide, repaglinide and metformin hydrochloride, rifaximin, rizatriptan, sargramostim, sertraline, sumatriptan, taliglucerase alfa, tamsulosin, thalidomide, tiagabine, tolmetin, topiramate, travoprost, triazolam, trospium, zolmitriptan, zonisamide
Ear Nose Throat Retropharyngeal abscess
Endocrine Acromegaly, conn's Syndrome, gynecomastia, hyperthyroidism, hypothyroidism
Environmental No underlying causes
Gastroenterologic Abdominal distension, achalasia, Barret’s esophagus, Bergman syndrome, cholecystitis, cholelithiasis, diverticulitis, duodenitis, 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, peritonitis, Plummer-Vinson Syndrome, pneumoperitoneum rumination disorder, splenic enlargement, splenic infarction, subdiaphragmatic abcsess, subphrenic abscess, Whipple's Disease
Genetic Fabry disease , familial hypercholesterolemia, familial mediterranean fever, recurrent hereditary polyserositis
Hematologic Acute intermittent porphyria, autoimmune hemolytic anemia, blood transfusion complication, langerhans' cell histiocytosis , lymphangiomyomatosis, pulmonary embolism, sickle cell anemia
Iatrogenic No underlying causes
Infectious Disease Alveolar hydatid disease, ankylostomiasis, Bornholm disease, chagas disease, cryptococcosis, hepatitis, herpes zoster, Herpes zoster,Actinomyces, histoplasmosis, HIV infection, lassa fever, Legionnaires' disease, mycoplasma pneumonia, peritonitis, pneumonia, Pott's Disease, Subdiaphragmatic abcsess, trichinella spiralis
Musculoskeletal/Orthopedic SAPHO syndrome, Ankylosing spondylitis , Bechterew's Disease, chest wall pain syndrome, chondritis, costosternal tendinitis, connective tissue disease, chondritis, costochondritis, costochondrol tendinitis, degenerative changes of cervical spine, fibromyalgia, fractured rib, intercostal muscle spasm, intercostal neuralgia, interstitial fibrosis, muscle strain or spasm, musculoskeletal pain , myofascial pain, myostitis, Pectus excavatum, periostitis, precordial catch syndrome shoulder bursitis, radiculitis, rib pain, SAPHO syndrome, shoulder tendinitis, Soft tissue sarcoma or tumor, sternoclavicular arthritis, strain of pectoralis muscle, thoracic outlet syndrome, Tietze's syndrome, vertebrogenic thoracic pain, xiphodynia
Neurologic Acute spinal cord injury, migraine headache, neuritis, shingles, tabes dorsalis
Nutritional/Metabolic Glycogenosis
Obstetric/Gynecologic Mastalgia, Mondor's disease, thelarche
Oncologic Bone tumor, bronchial carcinoma, bronchogenic carcinoma, liver cancer, langerhans' cell histiocytosis, mediastinal tumor, mesothelioma, metastatic tumor, neurofibroma, pheochromocytoma, pleural fibroma
Ophthalmologic No underlying causes
Overdose/Toxicity No underlying causes
Psychiatric Affective disorders (e.g., anxiety disorders, chronic fatigue syndrome, Da costa's syndrome, depression), fabricated or induced illness, factitious disorders (e.g. münchausen syndrome, fixed delusions) hyperventilation syndrome, functional disorders, hospital addiction syndrome, hypochondria, panic attack, somatization disorder, somatoform disorders, thought disorders
Pulmonary Alveolar hydatid disease anthracosis, asbestosis, asthma, barotrauma, bronchial carcinoma, bronchiectasis, bronchitis, bronchogenic carcinoma, bronchogenic cyst, chronic cough, chronic obstructive pulmonary disease (COPD), cor pulmonale, empyema, foreign body aspiration Goodpasture's syndrome, hemothorax, hyperventilation, Interstitial lung disease, laryngotracheitis, legionnaires' disease, lung abscess, lung Cancer, lymphoma, mediastinitis, mesothelioma, mycoplasma pneumonia, 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, wegner's granulomatosis
Renal/Electrolyte Goodpasture's syndrome , Wegner's granulomatosis
Rheumatology/Immunology/Allergy Atopy, autoimmune hemolytic anemia , chondritis, connective tissue disease, costochondritis, degenerative changes of cervical spine, familial mediterranean fever, fibromyalgia, Goodpasture's syndrome, langerhans' cell histiocytosis, recurrent hereditary polyserositis, Wegner's granulomatosis
Sexual No underlying causes
Trauma Acute spinal cord injury, barotrauma, chest wall injuries
Urologic No underlying causes
Miscellaneous Air embolism,Chinese restaurant syndrome, decompression sickness , Idiopathic

References

  1. ↑ Wächter C, Markus B, Schieffer B (2017). "[Cardiac causes of chest pain]". Internist (Berl). 58 (1): 8–21. doi:10.1007/s00108-016-0165-0. PMID 27981367.
  2. ↑ Hoorweg, Beatrijs BN; Willemsen, Robert TA; Cleef, Lotte E; Boogaerts, Tom; Buntinx, Frank; Glatz, Jan FC; Dinant, Geert Jan (2017). "Frequency of chest pain in primary care, diagnostic tests performed and final diagnoses". Heart. 103 (21): 1727–1732. doi:10.1136/heartjnl-2016-310905. ISSN 1355-6037.
  3. ↑ Gawinecka J, Schönrath F, von Eckardstein A (2017). "Acute aortic dissection: pathogenesis, risk factors and diagnosis". Swiss Med Wkly. 147: w14489. doi:10.4414/smw.2017.14489. PMID 28871571.
  4. ↑ Hoorweg BB, Willemsen RT, Cleef LE, Boogaerts T, Buntinx F, Glatz JF; et al. (2017). "Frequency of chest pain in primary care, diagnostic tests performed and final diagnoses". Heart. 103 (21): 1727–1732. doi:10.1136/heartjnl-2016-310905. PMID 28634285.
  5. ↑ Swierzy M, Helmig M, Ismail M, Rückert J, Walles T, Neudecker J (2014). "[Pneumothorax]". Zentralbl Chir. 139 Suppl 1: S69–86, quiz S87. doi:10.1055/s-0034-1383029. PMID 25264729.
  6. ↑ Lenfant C (2010). "Chest pain of cardiac and noncardiac origin". Metabolism. 59 Suppl 1: S41–6. doi:10.1016/j.metabol.2010.07.014. PMID 20837193.
  7. ↑ Jany B (2017). "[Pulmonary causes of chest pain]". Internist (Berl). 58 (1): 22–28. doi:10.1007/s00108-016-0169-9. PMID 27986981.
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