Chest pain: Differential diagnosis Cardiovascular: Acute coronary syndromeAnginaAortic dissection.ArrhythmiaValve diseaseAcute pericarditis (pleuritic).Cardiac tamponade.Stress (Takotsubo) cardiomyopathy. Pleuritic chest pain i.e. pain on inspiration, is a sign of pleural inflammation. Caused by: PneumoniaPEPneumothoraxPericarditisViral pleurisy.Lung cancer.Pleural effusion. GI: GORD: commonest non-cardiovascular cause.Peptic ulcer disease.GallstonesPancreatitis Other: Musculoskeletal: trauma, costochondritis.Anxiety: panic attack.Functional: chest wall syndrome.Shingles. Pain may come before rash.