Acute Chest Syndrome Symptoms and Diagnosis

What Are the Symptoms of Acute Chest Syndrome?

The signs and symptoms of acute chest syndrome can vary. Children are more likely to have an infection that will present respiratory symptoms and fever. Adults are more likely to have pain in the chest, arms, and legs, as well as shortness of breath and vaso-occlusive pain episodes. 

The most common symptoms are:

  • Shortness of breath
  • Wheezing
  • Rapid shallow breathing (tachypnea)
  • Cough, which may contain blood
  • Fever
  • Chest or back pain
  • Vaso-occlusive pain

How to Diagnose Acute Chest Syndrome?

It is important to get immediate medical treatment if you suspect ACS. If you go to an emergency room or hospital, you should notify them that you have sickle cell disease. During your exam, your physician will conduct a physical exam and ask about your personal history, including any potential risk factors. They will listen to your breathing with a stethoscope, order a chest X-ray and measure your oxygen saturation levels. Doctors define Acute Chest Syndrome as the appearance of new shadows on the chest X-ray along with fever and respiratory symptoms in a person with Sickle cell disease.

Common tests that may be ordered are:

  • Chest X-ray of your heart and lungs
  • Pulse oximetry to measure oxygen saturation
  • Blood tests including complete blood count, metabolic panel, cultures (to rule out infection), type and cross match (due to the potential need for transfusion) 
  • Bronchoscopy with BAL to evaluate other sources of infection if symptoms are not improving with supportive care and antibiotics
  • A CTA or computed tomographic angiography is a special type of X-ray that is the most common test used to diagnose pulmonary embolism because it uses contrast to analyze blood vessels. A Ventilation perfusion scan may be ordered instead if you are allergic to the dye used for a CTA.
  • D-Dimer (blood test) to screen for possible pulmonary emboli
  • Ultrasound of the legs to measure blood flow speed
  • Electrocardiogram to record heart activity
  • MRI is usually reserved for pregnant women and individuals that may not be able to tolerate the contrast used in other imaging tests 

Page last updated: June 23, 2022

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