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, 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, cytarabine,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	Fabry disease , familial hypercholesterolemia, familial mediterranean fever, glycogenosis, recurrent hereditary polyserositis
Hematologic	Sickle cell anemia, acute intermittent porphyria, lymphangiomyomatosis, autoimmune hemolytic anemia, langerhans' cell histiocytosis
Iatrogenic	Blood transfusion complication, cardiopulmonary resuscitation
Infectious Disease	Actinomyces, alveolar hydatid disease, ankylostomiasis, Bornholm disease, chagas disease, cryptococcosis, hepatitis, herpes zoster, histoplasmosis, HIV infection, lassa fever, Legionnaires' disease, mycoplasma pneumonia, pneumonia, Subdiaphragmatic abcsess, trichinella spiralis
Musculoskeletal / Ortho	Ankylosing spondylitis , Bechterew's Disease, bone tumor, chest wall pain syndrome, chondritis, costo sternal tendinitis connective tissue disease, costochondritis, costochondrol tendinitis, fibromyalgia, fractured rib, Intercostal muscle spasm, Intercostal neuralgia, Interstitial fibrosis, muscle strain or spasm, musculoskeletal pain , myofascial pain, myostitis, neuritis, 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
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	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 (e.g.
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	Acute spinal cord injury, barotrauma, Chest wall injuries, trauma
Miscellaneous	barotrauma, chinese restaurant syndrome, Collagen vascular disease with pleuritis, Conn's Syndrome, decompression sickness , degenerative changes of cervical spine, Idiopathic, mastalgia, Mondor's disease, peritonitis, Pott's Disease, xiphodynia

Causes in Alphabetical Order

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