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Important causes of chest pain

Last reviewed dd mmm yyyy. Last edited dd mmm yyyy

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In these conditions, speed is as important as thoroughness.

The serious (potentially fatal) causes include:

  • myocardial infarction (non-ST elevation myocardial infarction, ST elevation myocardial infarction)

  • aortic dissection:
    • severe pain sudden onset
    • asymmetric pulses or aortic regurgitation
    • widened mediastinum on chest radiology

  • pulmonary embolism:
    • pleuritic chest pain
    • at risk of DVT
    • hypoxia despite clear lungs on chest radiology

  • oesophageal rupture:
    • pain following vomiting
    • chest radiograph shows left pleural effusion with gas in the mediastinum

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