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Chest Pain Differential Diagnosis

Systematic evaluation of chest pain in the emergency department.

Written by: Saygı Hospital Health Guide Editorial Board
Last updated:

This content has been compiled by the Saygı Hospital Health Guide Editorial Board and is periodically reviewed by a specialist physician.

This content is for informational purposes only and does not constitute medical advice. You can book an appointment at our Kardiyoloji department. Book Appointment →

What is Chest Pain Differential Diagnosis?

Chest pain is one of the most common reasons for emergency department visits. Life-threatening causes (ACS, PE, aortic dissection, tension pneumothorax) must be excluded rapidly.

The HEART score (History, EKG, Age, Risk factors, Troponin) is used to assess acute coronary syndrome risk. Non-cardiac causes of chest pain include gastroesophageal reflux, musculoskeletal pain, and anxiety.

Symptoms

Pressing, squeezing, or burning pain
Radiation to the arm, jaw, or back
Association with shortness of breath
Relationship with exertion
Change with position (pleuritic or musculoskeletal)
Relationship with meals (reflux)

Risk Factors

Coronary artery disease risk factors
Deep vein thrombosis risk factors
Marfan syndrome (aortic dissection)
Smoking (pneumothorax)
Recent surgery or immobilization (PE)

When to See a Doctor?

If you experience any of the following symptoms, seek medical attention promptly:

  • New-onset chest pain >15 minutes — EMERGENCY
  • Accompanied by shortness of breath, sweating, or fainting
  • Tearing pain radiating to the back (aortic dissection?)
  • Unilateral chest pain + shortness of breath (pneumothorax?)

Treatment Methods

01
EKG (within the first 10 minutes)
02
Troponin (serial measurements — 0/1h or 0/3h)
03
HEART score assessment
04
Chest X-ray (pneumothorax, pleural effusion)
05
CT pulmonary angiography (in suspected PE)
06
CT angiography in suspected aortic dissection

Which Department to Visit?

You can visit our Kardiyoloji department for these complaints. Our specialist physicians will create the most suitable treatment plan for you.

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You can make an appointment with our specialists or contact us for your concerns.

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Health Disclaimer: The information on this page is prepared for general informational purposes only. It does not replace medical diagnosis and treatment. Please consult your physician for your complaints. Saygı Hospital does not accept responsibility for actions taken based on the information on this page.