Differential Diagnosis for 87 year old man post-fall with pulse ox of 90% and dyspnea
- Single most likely diagnosis
- Pulmonary contusion or pneumonia: Given the patient's age and presentation after a fall, a pulmonary contusion or pneumonia is highly likely. The fall could have caused trauma to the lungs, and the patient's age puts him at higher risk for developing pneumonia.
- Other Likely diagnoses
- Rib fracture: A fall in an elderly patient can easily result in rib fractures due to osteoporosis, which can cause dyspnea and decreased pulse oximetry readings.
- Chronic obstructive pulmonary disease (COPD) exacerbation: If the patient has a history of COPD, the stress of the fall and potential pulmonary injury could exacerbate his condition.
- Heart failure exacerbation: The fall and subsequent stress could also exacerbate pre-existing heart failure, leading to dyspnea and decreased oxygen saturation.
- Do Not Miss diagnoses
- Pneumothorax: Although less likely, a pneumothorax is a potentially life-threatening condition that could occur after a fall, especially if there was trauma to the chest. It requires immediate diagnosis and treatment.
- Pulmonary embolism: Given the patient's age and recent trauma, there is a risk of pulmonary embolism, which is a medical emergency.
- Cardiac tamponade: If the fall caused cardiac trauma, cardiac tamponade is a possibility, which would require immediate intervention.
- Rare diagnoses
- Diaphragmatic rupture: This is a rare but possible injury from the fall, which could cause respiratory distress.
- Fat embolism syndrome: Although rare, this condition can occur after a fall, especially if there were fractures, and can cause respiratory distress among other symptoms.