Differential Diagnosis for 65 y/o Female with Chest Flutter
Single Most Likely Diagnosis
- Atrial Fibrillation: This is the most common cardiac arrhythmia, especially in the elderly population. The symptoms of chest flutter, palpitations, and shortness of breath are consistent with atrial fibrillation, making it the single most likely diagnosis.
Other Likely Diagnoses
- Supraventricular Tachycardia (SVT): SVT is a condition characterized by an abnormally fast heart rate that originates above the ventricles. The symptoms of chest flutter and palpitations are consistent with SVT.
- Ventricular Tachycardia: Although less common, ventricular tachycardia can cause symptoms of chest flutter and palpitations, especially in patients with underlying heart disease.
- Mitral Valve Prolapse: This condition can cause palpitations, chest discomfort, and shortness of breath, which may be perceived as a chest flutter.
Do Not Miss Diagnoses
- Myocardial Infarction (MI): Although the presentation may be atypical, MI should always be considered in patients with chest symptoms, especially in the elderly population. A missed diagnosis of MI can be catastrophic.
- Pulmonary Embolism (PE): PE can cause sudden onset of chest pain, shortness of breath, and palpitations, which may be perceived as a chest flutter. Missing this diagnosis can be fatal.
- Cardiac Tamponade: This is a life-threatening condition that can cause chest pain, shortness of breath, and palpitations. Although rare, it should always be considered in patients with chest symptoms.
Rare Diagnoses
- Wolff-Parkinson-White Syndrome: This is a rare condition characterized by an accessory electrical pathway in the heart, which can cause SVT and symptoms of chest flutter.
- Arrhythmogenic Right Ventricular Cardiomyopathy (ARVC): This is a rare genetic disorder that can cause ventricular arrhythmias and symptoms of chest flutter.
- Thyrotoxicosis: Hyperthyroidism can cause palpitations, chest discomfort, and shortness of breath, which may be perceived as a chest flutter. Although rare, it should be considered in patients with unexplained chest symptoms.