Following are the causes of chest pain with breathlessness
- Spontaneous pneumothorax.
- Acute myocardial infarction-Occurs in middle aged or aged persons ,characterised by retrosternal pain with radiation to left hand, associate with drenching sweat and shock. Breathlessness with signs of heart failure may occur.
- Acute pulmonary thromboembolism - Sudden onset of chest pain with dyspnoea, haemoptysis and circulatory collpase develop. Tachycardia, right ventricular gallop rhythm, loud P2 are the clinical sign present.There is normal resonant note on percussion over the chest. History of prolonged recumbency or signs of thrombophlebitis may be noted.
- Dissection of aorta - Abrupt onset of chest pain with dyspnoea and will mimick acute myocardial infarction with pain referred to the back. There is discrepancy between carotid pulses difference in BP in two arms, arrhythmia and features of acutely developing aortic regugitation. Dissection of aorta occur more commonly in Marfans syndrome, hypertension, coarctation and pregnancy
- Acute dry pleurisy (specially from consolidation) - Dyspnoea is not so common in this situation but chest pain is present. Pleural Friction rub is audible and no sign of pneumothorax can be detected.
- Massive collapse of the lung -There will be history of aspiration of foreign body .Mediastinalshifting is noted towards the side of collapse. Impaired resonance note on percussion. Breath sound is diminished vesicular or absent.
- H/O trauma can also produce chest pain with dyspnea. Point of tenderness may be detected. Normal resonant note on percussion.Typical findings of pneumothorax are lacking.
- Psychogenic condition can also produce chest pian with dyspnea
