UMEM Educational Pearls

Category: Orthopedics

Title: Orthopedic Causes of Chest Pain

Keywords: Orthopaedic, Chest Pain (PubMed Search)

Posted: 2/28/2015 by Michael Bond, MD (Updated: 7/18/2024)
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Orthopedic Causes of Chest Pain

The first thing that pops into everybody’s mind when they hear a patient state they have chest pain radiating to the left arm is Acute Coronary Syndrome and specifically a Myocardial Infarction. However, there are a lot of orthopedic causes of chest pain that can also radiate to the left arm. It is estimate that up to 20% of patients with pectoral symptoms have an underlying orthopedic problem.

Some of them are:

  • Herniated Disc
  • Cervicothoracic tension syndrome
  • Blockage of intervertebral or rib joints
  • intercostal neuralgia


Some other less common causes are

  • Arthritis of the shoulder
  • Spondylocystitis
  • Osteoporotic fractures
  • Bone tumors


So instead of just ordering some troponin and admitting to medicine, consider that the cause can be orthopedic in origin.

References

Fromm B. Often an orthopedic problem can manifest as chest pain. Cervical vertebrae syndrome mimics myocardial infarct. MMW Fortschr Med 2002 Apr 25; 144(17):31-3.

http://www.ncbi.nlm.nih.gov/pubmed/12048845