First consider and exclude life-threatening causes:

  • Acute myocardial infarction
  • Angina/acute coronary syndrome
  • Aortic dissection
  • Tension pneumothorax
  • Pulmonary embolism
  • Oesophageal rupture

Then consider others potential causes of chest pain:

  • Pneumonia
  • Gastro-oesophageal reflux
  • Pleurisy
  • Empyema
  • Pericarditis
  • Oesophageal spasm
  • Herpes zoster
  • Cervical spondylitis
  • Chest wall pain
    • Muscular
    • Rib fracture(s)
    • Costochondritis
  • Intra-abdominal
    • Cholecystitis
    • Peptic ulceration
    • Pancreatitis
  • Sickle-cell crisis

Adapted from the Oxford Handbook of Clinical Medicine.

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