Common conditions that may mimic cardiac chest pain - Dr Srikant Sharma

Dr Srikant Sharma and Dr.Satyanarayan Mohapatra have compiled some medical conditions that may present as chest pain simulating cardiac pain in their article.

There may be several common medical conditions presenting with chest pain that may mimic cardiac chest pain. Non-Cardiac Chest Pain is the medical terminology used for chest pain which is not related to any specific heart condition but is quite similar to pains experienced due to pain from a cardiac condition. The per cent wise break up of incidence of different types of Chest Pain is depicted below.

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Q. No 1: Pt came with C/O sudden onset , severe intensity /sharp /stabbing /tearing chest pain, retrosternal / interscapular / radiating to back.

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Q. No 2: Pt with C/O chest pain, dyspnoea and hemoptysis.

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Q. No 3: Pt came with C/O heart burn-after eating -worst at night, dysphagia, hoarseness, coughing and wheezing.

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Q. No -4 Pt came with C/O sharp, stabbing chest pain, localized with one finger, worsened with coughing, sneezing and deep breathing.

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Q.No- 5: Pt presented with C/O Chest pain with hemoptysis, fever with the chill, shortness of breath, cough with sputum.

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Q No- 6: Pt with c/o Sudden onset unilateral chest pain and breathlessness

• On palpation: Mediastinal displacement


• On percussions: Resonant


• On auscultation: Decreased or absent breath sounds

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Q No - 7: pt came with h/o pain vary with posture, position and local tenderness over the 2nd rib.

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Q. No-8: An alcoholic pt came with c/o sudden onset, severe retrosternal chest pain, difficulty or painful swallowing & hematemesis.

• On auscultation: Mediastinal crunch (Hamman sign)

Mackler’s Triad

Lower chest pain, Vomiting and Subcutaneous emphysema.

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Q. No. 9 Pt came with c/o severe chest pain with difficulty in swallowing to liquid and solid.

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Q.No 10: Pt came with h/o chest pain dysphagia , odynophagia and regurgitation of undigested food.

Q. No 11: Pt came with c/o difficulty in swallowing for liquid and solid, regurgitations with angina-like chest pain.

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Q. No-12: Pt came with c/o chest pain, abdominal pain, burping, belching and difficulty in swallowing.

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Q. No-13: Pt came with c/o chest pain, trouble in swallowing, vomiting and hoarseness of voice.

• Destruction or dissapear mucosa


• Narrow of the lumen,


• Irregular crater


• Weakened /dissapear of peristalsis

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Q.No 14: Pt came with sudden onset of severe substernal chest pain, worsened by breathing and coughing and unrelieved by opiates, associated with fever, chill and prostrations O/E pt is restless and irritable.

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Q. No 15: Pt came with c/o Chest pain, h/o unpleasant incidence, hyperventilation and tingling sensation

• Physical examination -normal


• X-ray chest within normal limit.


• ABG : Respiratory Alkalosis.

 

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Answers to the Questions -

Q1: Diagnosis -Aortic Dissection

Q2: Diagnosis-Pulmonary Embolism

Q3: Diagnosis-GERD

Q4: Diagnosis- Pleuritic chest pain

Q5: Diagnosis-Pneumonia

Q6: Diagnosis-Acute Pneumothorax

Q7: Diagnosis-Costochondritis (teitz syndrome)

Q8: Diagnosis-Boerhaave syndrome (esophageal rupture)

Q9: Diagnosis-Nut cracker esophagus

Q10: Diagnosis-Achalasia Cardia

Q11: Diagnosis-Diffuse Esophageal Spasm

Q12: Diagnosis-Hiatus Hernia

Q13: Diagnosis- Esophageal malignancy

Q14: Diagnosis-Acute mediastinitis

Q15: Diagnosis-Anxiety disorder with chest pain

Authors of article are Dr. Srikant Sharma a Senior consultant in internal medicine New Delhi and Dr.Satyanarayan from, Moolchand Medcity.