What could be causing my recent symptoms of wheezing, chest tightness, and chills without fever, given my history of hypothyroidism, total hysterectomy, ear tubes, and use of Zepbound (tirzepatide) for weight loss, following a recent cold virus infection?

Differential Diagnosis

• Single most likely diagnosis
  • Acute bronchitis: This is the most likely diagnosis given the patient's recent history of a cold virus, symptoms of runny nose and sinus drainage, scratchy throat, and the development of wheezing and chest tightness. The absence of fever and the self-limiting nature of the symptoms also support this diagnosis.
• Other Likely diagnoses
  • Viral pharyngitis: The patient's symptoms of a scratchy throat and recent cold virus infection make viral pharyngitis a possible diagnosis.
  • Allergic rhinitis: The patient's history of ear tubes and symptoms of runny nose and sinus drainage could be indicative of allergic rhinitis, especially if the patient has allergies.
  • Asthma exacerbation: The patient's symptoms of wheezing and chest tightness could be indicative of an asthma exacerbation, although there is no mention of a pre-existing asthma diagnosis.
• Do Not Miss (ddxs that may not be likely, but would be deadly if missed.)
  • Pneumonia: Although the patient does not have a fever, pneumonia is a potentially life-threatening condition that should be considered, especially in patients with a history of hypothyroidism, which may affect the immune system.
  • Pulmonary embolism: The patient's symptoms of chest tightness and wheezing, combined with the recent history of staying up late and potential dehydration, make pulmonary embolism a possibility that should not be missed.
  • Cardiac ischemia: The patient's symptoms of chest tightness and wheezing could be indicative of cardiac ischemia, especially in a patient with a history of weight loss medication use, which may have cardiovascular side effects.
• Rare diagnoses
  • Hypothyroidism exacerbation: Although the patient has a history of hypothyroidism, an exacerbation of this condition is unlikely to cause the acute respiratory symptoms described.
  • Interstitial lung disease: This is a rare condition that could cause the patient's symptoms of wheezing and chest tightness, but it would be unusual in the absence of other symptoms or a pre-existing diagnosis.