Cardiac conditions - Hypertrophic cardiomyopathy
- Aortic stenosis
- Coarctation of the aorta
- Coronary artery abnormalities (eg, Kawasaki disease, anomalous coronary arteries)
- Variant angina after recreational drug use (eg, cocaine, amphetamines, bath salts [methcanthinones], marijuana, and synthetic cannabinoids)
- Classic angina (early atherosclerotic disease from hyperlipidemias or diabetes mellitus)
- Pericarditis
- Myocarditis
- Dilated cardiomyopathy
- Tachyarrhythmias
- Aortic aneurysm or dissection
- Ruptured sinus of Valsalva aneurysm
Airway foreign body Spontaneous pneumothorax Pulmonary embolism Pulmonary hypertension Sickle cell disease with acute chest syndrome Tumor (chest wall, pulmonary, or mediastinum) Nontraumatic esophageal rupture (Boerhaave syndrome) Spinal cord compression (tumor, vertebral collapse, or epidural abscess) |
Musculoskeletal conditions - Muscle strain
- Costochondritis
- Slipping rib syndrome
- Precordial catch (Texidor twinge)
- Fibromyalgia
- Pectus excavatum or carinatum
Psychiatric - Anxiety
- Panic disorder with or without hyperventilation syndrome
- Depression
- Hypochondriasis
- Somatization
Respiratory - Pneumonia (can be life threatening)
- Asthma (can be life threatening)
- Chronic cough with muscle strain or, if severe, fractured rib
- Spontaneous pneumomediastinum
Gastrointestinal - Gastroesophageal reflux disease
- Medication-induced ("pill") esophagitis
- Esophageal foreign body
- Esophageal spasm and achalasia
- Gastritis
- Peptic ulcer
- Irritable bowel disease
- Cholecystitis
- Pancreatitis
Breast - Male adolescents: Gynecomastia
- Female adolescents: Pregnancy, thelarche, mastitis, or fibrocystic disease
Idiopathic |