The Drug-Induced Cardiotoxicity Website and App

XV.a

XV - Chest pain

Chest pain (acute or subacute), lone or prominent

Last update 07/01/2020

Typically noncardiac. See also under XIu. See also under pill-induced esophageal pathologies under XIh, XIi, XIk and XIax that may cause substernal pain. Dedicated review at PMID 9403280. See also under Vi. Can be substernal, or in other areas of the chest. Can be acute, transfixiating and worrisome. Sometimes called 'acute chest syndrome'. Lung findings on imaging can be minimal. Depending on drug and patient, this may correspond to acute pleuritis or pleuro-pneumonitis, subpleural consolidation, GERD, pulmonary vasospasm, tracheal irritation, acute coronary syndrome or remain unexplained (PMID 30697107). See also under pleuritic chest pain (XIc), drug-induced lupus, pleuro-pulmonary lupus and acute coronary syndrome. Differential diagnosis on imaging at PMID 26373647

Causative drugs

Frequency - Incidence

Incidence of cardiac adverse event(s) due to the specific drug as assessed by number of reported/published cases in the literature. Red digits in stars indicate: 0 = Very rare, questionable signal · 1 = < 10 cases · 2 = 10-50 cases · 3 = 50–100 cases · 4 = 100-200 cases · 5 = >200 cases

Evidence level/grade

Evidence level for cardiac adverse event(s) due to the specific drug as estimated using Hill’s (1965), Naranjo’s (1981), and Bégaud’s (1985) criteria applied to published cases. Blue digits in stars indicate: 0 = Questionable · 1 = Low · 2 = Moderate · 3 = Robust · 4 = Definite · 5 = Unquestionable, pathognomonic