What are the differential diagnoses for coronary heart disease?

Coronary artery disease (CAD) is a highly prevalent condition that poses a serious threat to patients’ lives and health, often leading to functional impairments in daily life. Even after the disease is brought under control, severe cases may result in long-term sequelae—a consequence that must not be underestimated. So, what are the differential diagnoses for coronary artery disease?

What Are the Differential Diagnoses for Coronary Artery Disease?

Differential diagnoses for CAD include conditions presenting with chest pain—such as trauma or pleuritis, pneumonia, gastroesophageal disorders, costochondritis, herpes zoster involving the thoracic region, neurasthenia, and poor sleep quality. CAD must be distinguished from other causes of chest pain; a key distinguishing feature is that non-cardiac chest pain typically arises from an underlying primary disease. For instance, trauma, pleuritis, or pneumonia can cause chest pain, but such pain is neither paroxysmal nor exertion-induced—and therefore does not meet the criteria for angina pectoris. Gastroesophageal disorders and costochondritis are frequently mistaken for angina, while thoracic herpes zoster can produce severe chest pain requiring careful differentiation. Neurasthenia and sleep disturbances may also manifest as chest pain and thus warrant clarification. Since CAD must primarily be differentiated from non-cardiac chest pain, affected patients should undergo appropriate diagnostic evaluations.

Treatment of CAD encompasses lifestyle modification, pharmacotherapy, interventional procedures, and coronary artery bypass grafting (CABG). Patients with CAD must adopt healthier lifestyles and address modifiable risk factors—including hypertension, hyperglycemia, and hyperlipidemia—to prevent the “three highs.” When myocardial ischemia occurs, prompt treatment is essential. Standard pharmacotherapy for CAD includes aspirin and other antiplatelet agents, statins, vasodilators, and nitrates. In cases of severe coronary artery stenosis, patients may continue to experience symptoms despite medication, necessitating interventional procedures such as percutaneous coronary intervention (PCI) with stent placement.

CABG is recommended for selected CAD patients. Both interventional therapy and CABG carry risks of postoperative complications, which require timely recognition and management. We hope this information proves helpful to you.