Skip to main navigation menu Skip to main content Skip to site footer

An Approach To:

Vol. 19 No. 2 (2021)

Approach to: Chest pain

September 27, 2020


The diagnosis of chest pain is not always due to a cardiac cause such as a myocardial infarction. In fact, non-cardiac causes of chest pain may present with similar signs and symptoms. This article delves into the differential diagnosis of chest pain using an anatomical approach and describes how a thorough history, physical examination as well as specific tests are required to confirm each diagnosis.


  1. Lentini S, Perrotta S. Aortic dissection with concomitant acute myocardial infarction: From diagnosis to management. J Emergencies, Trauma Shock. 2011 Apr;4(2):273–8.
  2. Vincent B. Young, William A. Kormos DAC. Blueprints Medicine. 6th ed. Wolters Kluwer; 2015. 416 p.
  3. Fass R, Achem SR. Noncardiac chest pain: Epidemiology, natural course and pathogenesis. J Neurogastroenterol Motil. 2011 Apr;17(2):110–23.
  4. Dries DJ. Chest Pain. Air Med J. 2016 May 1;35(3):107–10.
  5. Lenfant C. Chest pain of cardiac and noncardiac origin. Metabolism. 2010 Oct 1;59(SUPPL. 1):S41–6.
  6. McSweeney JC, Cody M, O’Sullivan P, Elberson K, Moser DK, Garvin BJ. Women’s Early Warning Symptoms of Acute Myocardial Infarction. Circulation. 2003 Nov 25;108(21):2619–23.
  7. Schey R, Villarreal A, Fass R. Noncardiac chest pain: Current treatment [Internet]. Vol. 3, Gastroenterology and Hepatology. Millenium Medical Publishing; 2007 [cited 2020 Aug 31]. p. 255–62. Available from: /pmc/articles/PMC3099272/?report=abstract
  8. Rushton S, Carman MJ. Chest Pain: If It Is Not the Heart, What Is It? Nurs Clin North Am. 2018 Sep 1;53(3):421–31.
  9. Lei WY, Wang JH, Wen SH, Yi CH, Hung JS, Liu TT, et al. Risk of acute myocardial infarction in patients with gastroesophageal reflux disease: A nationwide population-based study. PLoS One. 2017 Mar 1;12(3).
  10. Chen CH, Lin CL, Kao CH. Association between gastroesophageal reflux disease and coronary heart disease. Med (United States). 2016 Jul 1;95(27).
  11. Lau RK. Boerhaave syndrome. Pearls Pitfalls Emerg Radiol Var Other Difficult Diagnoses. 2010 Jan 1;125–7.
  12. Locke AB, Kirst N, Shultz CG. Diagnosis and Management of Generalized Anxiety Disorder and Panic Disorder in Adults. Am Fam Physician. 2015 May 1;91(9):617–24.
  13. Mcconaghy JR, Oza RS. Outpatient Diagnosis of Acute Chest Pain in Adults. Am Fam Physician. 2013 Feb 1;87(3):177–82.
  14. William E Cayley Jr. Diagnosing the cause of chest pain. Am Fam Physician. 2005;72(10):2012–21.
  15. Appleton C, Gillam L, Koulogiannis K. Cardiac Tamponade. Cardiol Clin. 2017 Nov 1;35(4):525–37.
  16. Cicala S, De Simone G, Roman MJ, Best LG, Lee ET, Wang W, et al. Prevalence and prognostic significance of wall-motion abnormalities in adults without clinically recognized cardiovascular disease: The strong heart study. Circulation. 2007 Jul 10;116(2):143–50.
  17. Hussain N, Parker MW, Henzlova MJ, Duvall WL. Stress-first Myocardial Perfusion Imaging. Cardiol Clin. 2016 Feb 1;34(1):59–67.
  18. Silaschi M, Byrne J, Wendler O. Aortic dissection: Medical, interventional and surgical management. Heart. 2017 Jan 1;103(1):78–87.
  19. Abou Ali A, Avgerinos ED, Chaer RA. Catheter-Directed Thrombolysis of Pulmonary Embolism. Curr Manag Venous Dis. 2018 Nov 25;389–403.


Download data is not yet available.