Differential Diagnosis

PNEUMOTHORAX
A collection of free air in the chest outside the lung that causes the lung to collapse.

 Spontaneous pneumothorax is caused by
- rupture of a cyst or a small sac on the surface of the lung.
- fractured rib
- any penetrating injury
- surgical invasion of the chest, or may be deliberately induced in order to collapse the lungs
 Secondary pneumothorax :
- Cystic fibrosis

 Symptoms :
- Sudden onset of chest pain
- Tightness in the chest
- Shortness of breath
- Rapid heart rate, rapid breathing
- Cough
- Fatigue
- Cyanosis

CHOLECYSTITIS
Inflammation of the gallbladder that occurs most commonly because of an obstruction of the cystic duct from cholelithiasis.

 Upper abdominal pain, often radiating to the tip of the right scapula
 Nausea and vomiting

ANXIETY
 Generalized Anxiety Disorder
 Obsessive-Compulsive Disorder (OCD)
 Panic Disorder
 Post-Traumatic Stress Disorder (PTSD)
 Social Phobia (or Social Anxiety Disorder)
Symptoms :
 Excessive, ongoing worry and tension
 An unrealistic view of problems
 Restlessness
 Irritability
 Muscle tension
 Headaches
 Sweating
 Difficulty concentrating
 Nausea
 The need to go to the bathroom frequently
 Tiredness
 Trouble falling or staying asleep
 Trembling
 Being easily startled

PULMONARY EMBOLISM
A blood clot in the lung. It usually comes from smaller vessels in the leg, pelvis, arms, or heart.

 Chest pain : sharp, sudden onset, and is worse when taking a deep breath (referred to as pleuritic chest pain).
 Shortness of breath
 Anxiety
 Cough : dry, may be associated with blood.
 Sweating
 Passing out

HIATUS HERNIA
Hiatal hernia is an anatomical abnormality in which part of the stomach protrudes through the diaphragm and up into the chest.
 Vast majority of hiatal hernias are of the sliding type, and most of them are not associated with symptoms.
 The larger the hernia, the more likely it is to cause symptoms.
 When sliding hiatal hernias produce symptoms, they almost always are those of gastroesophageal reflux disease (GERD) or its complications.
 Patients with GERD are much more likely to have a hiatal hernia than individuals not afflicted by GERD.

PEPTIC ULCER
Generally caused by Helicobacter Pylori infection and non-steroidal anti inflammatory drugs (NSAIDs)
Symptoms:
 Epigastric pain
 Nausea
 Vomiting
 Dyspepsia, including belching, bloating, distention, and fatty food intolerance
 Heartburn
 Chest discomfort
 Anorexia, weight loss
 Hematemesis or melena resulting from gastrointestinal bleeding
 Dyspeptic symptoms
ESOPHAGEAL REFLUX
Gastroesophageal reflux disease (GERD) occurs when the amount of gastric juice that refluxes into the esophagus exceeds the normal limit, causing symptoms with or without associated esophageal mucosal injury (ie, esophagitis).
 GERD :
Heartburn
Regurgitation
Nausea

ESOPHAGITIS
Esophagitis is a common medical condition usually caused by gastroesophageal reflux.

Symptoms :

 Heartburn (dyspepsia)
 Symptoms often are maximal while the person is supine, bending over, wearing tight clothing, or has eaten a large meal.
 Upper abdominal discomfort, nausea, bloating, and fullness.
 Dysphagia
 Odynophagia
 Cough, hoarseness, wheezing
 Hematemesis.