Coronary Artery Disease: Or something else? Differential Diagnosis

Respiratory System (J00-J99)

  • Bronchitis* – inflammation of the mucous membrane of the bronchi.
  • Mediastinitis – serious disease, with inflammation of the mediastinum.
  • Pleurisy* (pleurisy).
  • Pneumonia* (pneumonia)
  • Pneumothorax* – accumulation of air in the physiologically airless space between the lung and pleura.

Cardiovascular system (I00-I99)

  • Aortic aneurysm* , symptomatic – outpouching (aneurysm) of the aorta.
  • Aortic dissection* (synonym: aneurysm dissecans aortae) – acute splitting (dissection) of the wall layers of the aorta (aorta), with a tear of the inner layer of the vessel wall (intima) and a hemorrhage between the intima and the muscle layer of the vessel wall (outer media), in the sense of an aneurysm dissecans (pathological expansion of the artery).
  • Aortic valve stenosis* – narrowing of the outflow tract of the left ventricle.
  • Angina pectoris (stenocardia; “chest tightness”; sudden pain in the heart area) – the main symptom of coronary artery disease (CAD).
  • Angina decubitus – angina pectoris, which occurs at night from sleep, is triggered by lying flat in bed. The strictly horizontal position increases the backflow volume of blood!
  • Apoplexy* (stroke)
  • Asymptomatic coronary artery disease (CAD)
  • Dressler syndrome (synonyms: postmyocardial infarction syndrome, postcardiotomy syndrome) – pericarditis (inflammation of the pericardium) and/or pleurisy (inflammation of the pleura) occurring several weeks (1-6 weeks) after a myocardial infarction (heart attack) or injury to the myocardium (heart muscle) as a late immunological reaction at the pericardium (heart sac) after the formation of heart muscle antibodies (HMA).
  • Heart failure (cardiac insufficiency), acute* .
  • Hypertensive crisis/emergency* – blood pressure derailment with values > 200 mmHg.
  • Cardiomyopathy* (heart muscle disease).
  • Coronary spasm* (coronary artery spasm).
  • Pulmonary embolism* – occlusion of a pulmonary vessel by a blood clot.
  • Myocardial infarction, acute or subacute (heart attack).
  • Myocarditis* (inflammation of the heart muscle).
  • Pericarditis* (inflammation of the pericardium)
  • Spontaneous coronary artery dissection (SCAD) – rupture in the vessel wall of a coronary vessel; usually affects younger patients (< 50 years) without classic cardiovascular risk factors; clinical symptoms: manifestation with STEMI (synonyms: ST-segment elevation myocardial infarction), NSTEMI (synonyms: Non-ST-segment elevation myocardial infarction), ventricular arrhythmia (arrhythmia originating in one ventricle), or sudden cardiac death (PHT); 0.1-0.4% of all acute coronary syndromes.
  • Stress cardiomyopathy* (synonyms: Broken heart syndrome, Tako-Tsubo cardiomyopathy (Takotsubo cardiomyopathy), Tako-Tsubo cardiomyopathy (TTC), Tako-Tsubo syndrome (Takotsubo syndrome, TTS), transient left ventricular apical ballooning) – primary cardiomyopathy (myocardial disease) characterized by short-term impairment of myocardial (heart muscle) function in the presence of overall unremarkable coronary arteries; clinical symptoms: Symptoms of acute myocardial infarction (heart attack) with acute chest pain (chest pain), typical ECG changes, and increase in myocardial markers in the blood; in approx. 1-2% of patients with a suspected diagnosis of acute coronary syndrome are found to have TTC on cardiac catheterization instead of a presumed diagnosis of coronary artery disease (CAD); nearly 90% of patients affected by TTC are postmenopausal women; Increased mortality (death rate) in younger patients, especially men, largely due to increased rates of cerebral hemorrhage (brain bleeding) and epileptic seizures; possible triggers include stress, anxiety, heavy physical work, asthma attack, or gastroscopy (gastroscopy); risk factors for sudden cardiac death in TTC include: Male gender, younger age, prolonged QTc interval, apical TTS type, and acute neurological disorders; long-term incidence for apoplexy (stroke) after five years was significantly higher in patients with Takotsubo syndrome, 6.5%, than in patients with myocardial infarction (heart attack), 3.2
  • (Supra-) ventricular tachycardia – tachycardia in which it comes to heart rates of 150-220 beats/minute.
  • Tachyarrhythmias* – combination of too fast heart action (tachycardia) and a cardiac arrhythmia (arrhythmia).
  • Vitia (heart valve defects): especially aortic valve stenosis; mitral valve prolapse.

Infectious and parasitic diseases (A00-B99).

  • Herpes zoster* (shingles)

Liver, gallbladder, and bile ducts – Pancreas (pancreas) (K70-K77; K80-K87).

  • Cholecystitis* (gallbladder inflammation).
  • Gallstone colic
  • Pancreatitis* (inflammation of the pancreas)

Mouth, esophagus (esophagus), stomach, and intestines (K00-K67; K90-K93).

Musculoskeletal system and connective tissue (M00-M99)

  • Functional thoracic pain (chest pain) (non-organic chest pain).
  • Cervical spine syndrome
  • Musculoskeletal diseases* – inflammatory and degenerative diseases of the musculoskeletal system.
  • Myopathies* (muscle diseases) – muscle injury/inflammation.
  • Tietze syndrome* (synonyms: chondroosteopathia costalis, costochondritis, Tietze disease) – rare idiopathic chondropathy of the costal cartilages at the base of the sternum (painful sternal attachments of the 2nd and 3rd ribs), associated with pain and swelling in the anterior thoracic (chest) region.

Neoplasms – tumor diseases (C00-D48).

  • Bronchial carcinoma (lung cancer)
  • Metastases (daughter tumors)
  • Tumor in the mediastinum (mediastinal space, is a vertically running tissue space in the chest cavity).

Psyche – nervous system (F00-F99; G00-G99).

  • Anxiety disorders*
  • Depression, latent
  • Functional heart complaints
  • Panic attacks

Injuries, poisonings, and certain other consequences of external causes (S00-T98).

  • Cardiac trauma*
  • Thoracic trauma* (chest injury).

* Frequent differential diagnoses of acute chest pain and suspected acute coronary syndrome (ACS).