Pleuritic Pain (Pleurodynia): Or something else? Differential Diagnosis

Respiratory System (J00-J99)

Blood, blood-forming organs – immune system (D50-D90).

  • Sickle cell disease (sickle cell anemia) (Synonyms: African anemia; anemia due to sickle cell disease; drepanocytic anemia; drepanocytic anemia; drepanocytosis; elliptocytosis due to sickle cell disease; AS genotype hemoglobin; Hb-AS inherited disorder; HbS [sickle cell hemoglobin] disease; Hb-SC disease; Hb-SD disease; Hb-SE disease; Hb-S inherited disorder; Hb-SS disease with crises; Herrick syndrome; meniscocyte anemia; sickle cell anemia; sickle cell hemoglobinopathy; sickle cell anemia; sickle cell anemia); genetic disorder of erythrocytes that results in anemia (anemia). It is the most common hemoglobinopathy and is considered a multisystem disorder.

Endocrine, nutritional and metabolic diseases (E00-E90).

Cardiovascular system (I00-I99).

  • Angina pectoris (synonym: stenocardia, German: Brustenge) – seizure-like tightness in the chest (sudden pain in the area of the heart caused by a circulatory disorder of the heart). In most cases, this circulatory disturbance is due to a stenosis (narrowing) of the coronary vessels; this is caused by coronary heart disease (CHD) or acute coronary syndrome (ACS). ACS, acute coronary syndrome; spectrum of cardiovascular disease ranging from unstable angina (UA) to the two main forms of myocardial infarction (heart attack), non-ST elevation myocardial infarction (NSTEMI) and ST elevation myocardial infarction (STEMI))Note: In one study, the so-called typical chest pain for the diagnosis of acute coronary syndrome was shown to have only a 0.54 area under the curve in terms of its discriminatory ability: experienced physicians were 65.8% and novices 55.4%. After completion of treatment, only 15-20% of patients with chest pain were diagnosed with acute coronary syndrome.
  • Aortic aneurysm – circumscribed dilatation of the aorta due to congenital or acquired weakening of the arterial wall.
  • Aortic dissection (synonym: aneurysm dissecans aortae) – acute splitting (dissection) of the wall layers of the aorta (main artery), with a tear of the inner layer of the vessel wall (intima) and 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 stenosis – obstruction (narrowing) of the outflow tract of the left ventricle.
  • Acute aortic syndrome (AAS): clinical pictures that can lead directly or indirectly via aortic dissection (splitting (dissection) of the wall layers of the aorta) to a rupture (“tear”).
  • Pericardial tamponade – constriction of the heart by the pericardium.
  • Hypertrophic cardiomyopathy – weakness of the heart muscle with enlargement of the heart and a tendency to severe arrhythmias, especially under stress.
  • Unstable angina pectoris (UA; English unstable angina) – one speaks of an unstable angina pectoris, if the complaints have increased in intensity or duration compared to the previous angina pectoris attacks.
  • Kawasaki syndrome – acute, febrile, systemic disease characterized by necrotizing vasculitis (vascular inflammation) of the small and medium-sized arteries
  • Pulmonary embolismocclusion of one or more pulmonary vessels by a thrombus (blood clot).
  • Pulmonary infarction
  • Myocardial infarction (heart attack)
  • Myocarditis (inflammation of the heart muscle)
  • Pericardial effusion – accumulation of fluid in the pericardium.
  • Pericarditis (inflammation of the pericardium)
  • Prinzmetal’s angina – special form of angina pectoris (chest pain) with temporary ischemia (circulatory disorder) of the myocardium (heart muscle), triggered by a spasm (spasm) of one or more coronaries (coronary vessels) (symptoms: pain duration: seconds to minutes; load-independent, especially in the early morning hours); as the worst consequence of ischemia, a myocardial infarction (heart attack) can be triggered.
  • Postcardiotomy syndrome – symptoms occurring after heart surgery – similar to Dressler myocarditis; Dressler syndrome (synonyms: postmyocardial infarction syndrome, postcardiotomy syndrome) – several weeks (1-6 weeks) after a myocardial infarction (heart attack) or a myocardial injury occurring pericarditis (pericarditis) and / or pleurisy (pleurisy) as a late immunological reaction at the pericardium after the formation of myocardial antibodies (HMA).
  • Roemheld syndrome – reflex cardiac symptoms caused by gas accumulation in the intestines and stomach, usually from overeating or flatulent foods; symptomatology: Extrasystoles (heartbeat occurring outside the physiologic heart rhythm), sinus bradycardia (< 60 heartbeats/min), sinus tachycardia (> 100 heartbeats/min), angina pectoris (chest tightness; sudden onset of pain in the cardiac region), dysphagia (difficulty swallowing), syncope (brief loss of consciousness), vertigo (dizziness).
  • X syndrome – simultaneous presence of exercise-induced angina, a normal exercise ECG, and angiographically normal coronary arteries (arteries that surround the heart in a wreath shape and supply blood to the heart muscle)

Infectious and parasitic diseases (A00-B99).

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

  • Inflammatory bowel disease – ulcerative colitis, Crohn’s disease.
  • Gastroesophageal reflux disease (synonyms: GERD, gastroesophageal reflux disease; gastroesophageal reflux disease (GERD); gastroesophageal reflux disease (reflux disease); gastroesophageal reflux; reflux esophagitis; reflux disease; reflux esophagitis; peptic esophagitis) – inflammatory disease of the esophagus (esophagitis) caused by the abnormal reflux (reflux) of acidic gastric juices and other gastric contents; presents as reflux thoracic pain syndrome
  • Hollow organ perforation (esophagus, stomach).
  • Hiatal hernia – soft tissue hernia, through which the stomach is partially to fully displaced into the chest.
  • Esophageal motility disorders – disturbance of the movement of the esophagus.
  • Esophagitis (inflammation of the esophagus).
  • Esophageal rupture (Boerhaave syndrome) – spontaneous rupture of the esophagus (esophagus); usually after massive vomiting; possibly in alcohol excess.

Musculoskeletal system and connective tissue (M00-M99).

  • Chest wall syndrome – neuromusculoskeletal disorders.
  • Chest wall tumors, unspecified
  • Costochondritis – inflammation of the junctions where the ribs and sternum articulate (inflammation of the costochondral cartilage).
  • Fibromyalgia (fibromyalgia syndrome) – syndrome that can lead to chronic pain (at least 3 months) in several regions of the body.
  • Intercostal neuralgia – nerve pain (neuralgia) of the chest wall along an intercostal nerve; usually there is a pulling, persistent pain
  • Kostochondritis – inflammation of the rib cartilage.
  • Lupus erythematosus
  • Muscular overexertion
  • Myositis – inflammation of the muscles.
  • Rib fracture (rib fracture)
  • Shoulder joint arthritis (inflammation of the joint)
  • Shoulder joint bursitis (bursitis).
  • Tietze syndrome (synonyms: chondroosteopathia costalis, Tietze’s 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 thorax (chest) region
  • Thoracic wall syndrome – pain in the chest caused by muscular and skeletal changes.

Neoplasms – tumor diseases (C00-D48).

  • Bronchial carcinoma (lung cancer)

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

Medication

  • Cocaine (cocaine abuse)
  • Drug-induced lupus