Chest pain causes

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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]


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.


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


  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.