Chest Pain Made Worse By Breathing

What Causes Chest Pain Made Worse By Breathing?

Chest pain made worse by breathing can have various causes, ranging in severity from 'needs attention' to 'life-threatening'.  Finding the true cause means ruling out or confirming each possibility – in other words, diagnosis.

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Diagnosis is usually a complex process due to the sheer number of possible causes and related symptoms.  In order to diagnose chest pain made worse by breathing, we could:

  • Research the topic
  • Find a doctor with the time
  • Use a diagnostic computer system.
The process is the same, whichever method is used.

Step 1: List all Possible Causes

We begin by identifying the disease conditions which have "chest pain made worse by breathing" as a symptom.  Here are six possibilities:
  • Valley Fever (Coccidioidomycosis)
  • Pneumonia
  • Pulmonary Embolism
  • Lupus (SLE)
  • Pleurisy
  • Possible Urgent Medical Need

Step 2: Build a Symptom Checklist

We then identify all possible symptoms and risk factors of each possible cause, and check the ones that apply:
shortness of breath when at rest
Asian ethnicity
occasional unexplained fevers
frequent mouth ulcers
frequent 'chills'
very tender muscles
wearing dirty dentures all day
lupus
attempting suicide
significant right lumbar pain
multiple painful axillary nodes
severe stiff neck
... and more than 60 others

Step 3: Rule Out or Confirm each Possible Cause

A differential diagnosis of your symptoms and risk factors finds the likely cause of chest pain made worse by breathing:
Cause Probability Status
Lupus (SLE) 96% Confirm
Pleurisy 60% Possible
Pulmonary Embolism 18% Unlikely
Pneumonia 4% Ruled out
Possible Urgent Medical Need 1% Ruled out
Valley Fever (Coccidioidomycosis) 1% Ruled out
* This is a simple example to illustrate the process

Arriving at a Correct Diagnosis

The Analyst™ is our online diagnosis tool that learns all about you through a straightforward process of multi-level questioning, providing diagnosis at the end.

If you indicate having chest discomfort, The Analyst™ will ask further questions including this one:
If you are experiencing chest pain, how is it affected by breathing?
Possible responses:
→ Don't know
→ The pain is unrelated to breathing
→ It is worse only when I breathe in deeply
→ It is worse only when I breathe out deeply
→ It is worse when I breathe in or out
Based on your response to this question, which may indicate either chest pain unaffected by breathing or chest pain when breathing, The Analyst™ will consider possibilities such as:
A Potentially Urgent Medical Need

The sensation of a "catch" at the end of a deep breath is clinically important as a symptom of pulmonary embolism (a clot to the lung).  This requires immediate evaluation by a physician.

Lupus, SLE (Systemic Lupus Erythematosus)

Pain in the chest on deep breathing (pleurisy) is experienced by some 45% of lupus patients.

Pleurisy

The hallmark of pleurisy is severe chest pain that starts suddenly.  Often strong or stabbing when taking a deep breath or coughing, the pain usually subsides or disappears between breaths, and it is usually felt on one side of the stomach area or lower chest.

Pneumonia

The pain of lobar pneumonia often begins as a general sense of pressure and aching, usually localized to one side of the chest.  The pain begins around the time of the chills heralding the onset of the infection.  Later, as the process affects the pleura (tissues around the lung), pleuritic pain develops.  Patients with atypical pneumonia or bronchopneumonia may complain of a central burning sensation provoked by coughing.

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