Differential Diagnosis for 21-year-old Male with Chest Pain and Shortness of Breath
- Single most likely diagnosis:
- Anxiety/Panic Disorder: The patient has a history of anxiety/panic attacks, and his symptoms of chest pain, shortness of breath, tachycardia, and diaphoresis are consistent with panic attacks. The intermittent nature of his symptoms over several months and the absence of cardiac or pulmonary abnormalities also support this diagnosis.
- Other Likely diagnoses:
- Musculoskeletal Chest Pain: The patient's chest pain could be related to musculoskeletal issues, such as costochondritis or muscle strain, especially given the intermittent nature of his symptoms.
- Gastroesophageal Reflux Disease (GERD): The patient's abdominal pain and chest pain could be related to GERD, which is a common cause of chest pain in young adults.
- Pneumonia or Other Respiratory Infections: Although the patient has no history of pulmonary abnormalities, he was recently hospitalized for sepsis, which could increase his risk for respiratory infections.
- Do Not Miss diagnoses:
- Pulmonary Embolism (PE): Although the patient has no history of cardiac or pulmonary abnormalities, PE is a life-threatening condition that can present with chest pain and shortness of breath. His recent hospitalization for sepsis and immobility could increase his risk for PE.
- Acute Coronary Syndrome (ACS): Although the patient is young and has no history of cardiac abnormalities, ACS is a life-threatening condition that can present with chest pain and shortness of breath. His recent nicotine cessation could potentially increase his risk for ACS.
- Aortic Dissection: This is a rare but life-threatening condition that can present with chest pain and shortness of breath. Although the patient has no history of cardiac abnormalities, aortic dissection can occur in young adults with no prior history of cardiac disease.
- Rare diagnoses:
- Pneumothorax: This is a rare condition that can present with chest pain and shortness of breath. Although the patient has no history of pulmonary abnormalities, pneumothorax can occur in young adults with no prior history of lung disease.
- Cardiac Sarcoiodosis: This is a rare condition that can present with chest pain and shortness of breath. Although the patient has no history of cardiac abnormalities, cardiac sarcoidosis can occur in young adults with no prior history of cardiac disease.