Epigastric | Clinical features | Comments |
Acute myocardial infarction | May be associated with shortness of breath and exertional symptoms. | Consider particularly in patients with risk factors for coronary artery disease. |
Acute pancreatitis | Acute-onset, persistent upper abdominal pain radiating to the back. | |
Chronic pancreatitis | Epigastric pain radiating to the back. | Associated with pancreatic insufficiency. |
Peptic ulcer disease | Epigastric pain or discomfort is the most prominent symptom. | Occasionally, discomfort localizes to one side. |
Gastroesophageal reflux disease | Associated with heartburn, regurgitation, and dysphagia. | |
Gastritis/gastropathy | Abdominal discomfort/pain, heartburn, nausea, vomiting, and hematemesis. | Variety of etiologies including alcohol and nonsteroidal antiinflammatory drugs (NSAIDs). |
Functional dyspepsia | The presence of one or more of the following: postprandial fullness, early satiation, epigastric pain, or burning. | Patients have no evidence of structural disease. |
Gastroparesis | Nausea, vomiting, abdominal pain, early satiety, postprandial fullness, and bloating. | Most causes are idiopathic, diabetic, or postsurgical. |
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