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Severe Pain in the Lower Chest and Upper Abdominal Area

CLINICAL DIAGNOSTIC MANUAL



Severe Pain in the Lower Chest and Upper Abdominal Area


Cause

Main Characteristics

Symptoms and Signs

Confirmatory Diagnostic Tests

Gastritis and Gastroesophageal Reflux

Burning pain in the epigastrium, associated with meals or stressful situations

Heartburn, acid regurgitation, abdominal discomfort

Upper gastrointestinal endoscopy to evaluate the gastric and oesophageal mucosa

Biliary Colic

Intense colicky pain in the right upper quadrant

Nausea, vomiting, pain radiating to the back

Abdominal ultrasound to evaluate the gallbladder and detect gallstones

Pancreatitis

Persistent abdominal pain, may be epigastric

Nausea, vomiting, abdominal distension, signs of shock

Blood tests (amylase and lipase), abdominal ultrasound, and in some cases, computed tomography (CT)

Acute Myocardial Infarction (Typically Inferior)

Crushing pain, a sensation of pressure or burning in the centre of the chest

Shortness of breath, sweating, pain radiating to the left arm or jaw

Electrocardiogram (ECG), cardiac enzymes (troponin), echocardiogram, and coronary angiography if necessary


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