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

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

• Aortic dissection
• Coarctation of the aorta
• Hypertrophic cardiomyopathy
• Myocarditis
• Pericarditis
• Pulmonary embolism
• Spontaneous pneumothorax
• Unstable angina

Common Causes

• Achalasia
• Anxiety
• Costochondritis
• Depression
• Gastroesophageal reflux disease
• Pancreatitis
• Panic disorder
• Pneumonia
• Precordial catch

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, 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, 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 spiralis, ankylostomiasis, chagas disease, pneumonia, cryptococcosis, histoplasmosis, Legionnaires' disease, lassa 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 neuralgia, Muscle strain or spasm, Musculoskeletal pain , 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, mediastinal tumor, mesothelioma, metastatic tumor, neurofibroma, pheochromocytoma, Pleural fibroma, mesothelioma
Opthalmologic	No underlying causes •
Overdose / Toxicity	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, 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
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, Idiopathic, Peritonitis, Mondor's disease, Pott's Disease, Xiphodynia, Mastalgia, Barotrauma, Decompression sickness

Causes in Alphabetical Order

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