Differential diagnoses

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Differential diagnoses

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sarika
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10/17/05 - 07:58 PM

A 40 yr old female patient comes to ER with chest pain, shortness of breadth and sweating. ECG and enzymes normal. after administering o2 what would u do?

2.Whats the diffrential diagnoses?

I would still schedule a stress test....what do u guys think?

chemamr
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10/18/05 - 05:27 AM

cough? fever? pleuritic pain? CXR? BP? pheocromocytoma? PE? I think we should have more info about this patient, clinical findings, history.

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nisha
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10/18/05 - 07:50 AM

This is a very ambiguous case, but in my d/d I would include:

MI
stable/unstable angina
Pulm Embolus
asthma
pneumonia
GERD
trauma:tension pneumothorax, tamponade,aortic rupture
spontaneous pneumothorax
Choking
less probable: gallstones, and stomach ulcers (which can also present with chestpain)

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sarika
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10/18/05 - 09:29 AM

ok there was no fever, bp was normal.

Actually all ur d/d r good just add one thing...Perimenopausal symptoms!

Renegade
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10/18/05 - 01:14 PM

sarika wrote:
Perimenopausal symptoms!

At 40? Maybe suspect after 46... Can't be, of course, ruled out, yet it's very unlikely.

Stress test is a good idea, but once again, forty-ish female? Only if there were risk factors. And even if there were, only if no other cause was suspected.

Question: suppose she lived like NEXT to the hospital. Would you repeat ECG or enzymes later?

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nisha
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10/18/05 - 07:04 PM

Menopausal changes are possible after 40 years. I believe it is only premature only before 35. And u may want repeat the ECG with ergonovine to rule out prinzmetals angina. I just remembered, rule out panic attacks.

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