Angina Pectoris Differential Diagnoses

Updated: Jul 19, 2018
  • Author: Jamshid Alaeddini, MD, FACC, FHRS; Chief Editor: Eric H Yang, MD  more...
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Diagnostic Considerations

In patients with stable angina pectoris, even the most carefully performed history and physical examination have limitations. Classification of these patients solely on the basis of history and physical examination findings may lead to serious mistakes. Some type of stress testing is usually indicated to confirm the diagnosis and quantitate the severity of ischemia.

In women, elderly persons, and diabetic patients, coronary artery disease may manifest with atypical presentations other than angina pectoris, such as silent ischemia or infarction. Clinicians should use a careful approach when evaluating these patients.

Other conditions to consider in patients with suspected coronary artery disease include the following:

  • Esophageal spasm

  • Esophageal rupture

  • Costochondritis

  • Herpes zoster

  • Pneumonia with pleural involvement

Differential Diagnoses