Do not miss: ACS, PE, PTX, and other cardiovascular causes.
Cardiovascular
Acute Coronary Syndrome (ACS) – STEMI and NSTE-ACS (UA, NSTEMI)
Stable Angina (from CAD)
Aortic valve stenosis (causing angina) — E.g. stenosis from radiation to the chest or familial.
Mitral valve prolapse (can cause chest discomfort)
Pericarditis & myocarditis
Vasospastic angina (previously called Prinzmetal/variant angina)
Microvascular Angina
Dissecting aortic aneurysm / Aortic dissection
Musculoskeletal
Chest wall pain
Costochondritis
Precordial catch syndrome
Pulmonary
Pleuritis / pleuritic chest pain.
Asthma (can cause chest tightness or pain)
Pneumonia (& Bronchitis)
Tuberculosis
Pneumothorax
Acute chest syndrome in Sickle Cell Anemia
Pulmonary embolism (PE)
Pulmonary infarction (usually secondary to PE)
Pulmonary hypertension
Malignancy
Gastrointestinal
Gastroesophageal reflux disease (GERD)
Esophageal Spasm
Esophagitis
Peptic ulcer disease (PUD)
Esophageal tear (Mallory-Weiss)
Esophageal rupture (Boerhaave syndrome)
Pancreatitis
Biliary disease
Psychiatric
Panic disorder and Anxiety
Other causes
Shingles (Herpes Zoster, by Varicella Zoster virus)
Mediastinitis
Idiopathic chest pain
Spinal cord compression
Tumor
Thinking through the Differential Diagnosis
Boerhaave syndrome is a transmural perforation of the esophagus to be distinguished from Mallory-Weiss syndrome, a nontransmural esophageal tear also associated with vomiting.