Chest pain

The differentiation of chest pain into three categories (pleuritic, mediastinal/central, chest wall pain) improves the efficient diagnostic work-up. The patient presenting with chest pain is still a great diagnostic challenge for the clinician. Typical angina pectoris due to an acute coronary syndrome or myocardial infarction are the most prevalent diagnoses in the emergency department. How ever, acute chest pain of ten does not have a car diacetiology. Thus, other life-threatening conditions such as acute aortic dissection, acute pulmonary embolism, tension pneumothorax, and spontaneous rupture of the esoph-agus (Boer haave's syndrome) must be sought. The correct inter pretation of symptoms, efficient diagnostic work-up, and immediate adequate management of these emergency conditions are crucial. The differential diagnosis of chronic chest pain is complex. The assessment should in clude a detailed medical history and physical examination.