DIAGNOSIS CHECKLIST
for Chest pain

Why: to determine if acute or chronic. If acute onset must consider heart attack, pulmonary embolism, pneumothorax, pericarditis and rib fractures. If chest pain is chronic must consider angina, oesophagitis, hiatus hernia and various chest wall conditions.

Why: Constant pain suggests heart attack, pulmonary infarction, dissecting aneurysm and pneumonia. Intermittent pain would suggest angina, Tietze's syndrome and Da Costa's syndrome.

Why: e.g. heart attack and angina is typically behind the breastbone; dissecting aneurysm is behind the sternum.

Why: e.g. heart attack pain may radiate to neck, jaw and down left side of arm; esophageal pain may radiate to throat or back; dissecting aneurysm may radiate to between the shoulder blades, abdomen or legs.

Why: e.g. heart attack may be described as heavy and crushing; esophageal pain is usually burning; dissecting aneurysm is tearing and searing.

Why: e.g. if pain is relived by antacids should consider oesophagitis and hiatus hernia; if pain is relieved by nitroglycerine spray should suggest angina but may also be spasm of the esophagus.

Why: e.g. If the pain is precipitated or increased by breathing must consider pleurisy, costochondritis, fractured rib and pneumothorax; if pain is aggravated by movement suggests pericarditis; if pain is precipitated by bending, lifting, straining or lying down and is precipitated by certain foods a possible diagnosis is esophageal reflux or spasm.

Why: e.g. diabetes, high blood pressure, high cholesterol, obesity, heart surgery, Rheumatic fever, heart attack, asthma, emphysema, Marfan's syndrome (increases risk of dissecting aneurysm), deep venous thrombosis.

Why: e.g. heart attack, angina, heart bypass surgery.

Why: must consider pulmonary embolism.

Why: should consider pneumonia.

Why: should consider pneumothorax, pulmonary embolism, pneumonia and congestive heart failure due to heart attack.

Why: may suggest reflux oesophagitis.

Why: suggests herpes zoster (shingles).

Why: e.g. nervousness, tremor, palpitations, shortness of breath, rapid breathing.