Differential Diagnosis for 70yo F with Gradual Worsening Fatigue, Malaise, and Hypotension
- Single Most Likely Diagnosis
- Dehydration: This is a common condition in the elderly, especially if they have decreased oral intake or increased fluid loss due to various reasons such as diarrhea, vomiting, or excessive sweating. Dehydration can lead to hypotension, fatigue, and malaise.
- Other Likely Diagnoses
- Anemia: A decrease in red blood cell mass or hemoglobin can cause fatigue, malaise, and hypotension. Anemia is common in the elderly due to chronic diseases, nutritional deficiencies, or blood loss.
- Heart Failure: Decreased cardiac output can lead to fatigue, malaise, and hypotension. Heart failure is a common condition in the elderly, especially those with a history of hypertension, coronary artery disease, or valvular heart disease.
- Adrenal Insufficiency: This condition occurs when the adrenal glands do not produce enough cortisol and aldosterone, leading to hypotension, fatigue, and malaise.
- Do Not Miss Diagnoses
- Sepsis: Although less likely, sepsis is a life-threatening condition that requires prompt recognition and treatment. Elderly patients may present with non-specific symptoms such as fatigue, malaise, and hypotension.
- Myocardial Infarction: Elderly patients may have atypical presentations of myocardial infarction, including fatigue, malaise, and hypotension, rather than the typical chest pain.
- Pulmonary Embolism: This condition can also present with non-specific symptoms such as fatigue, malaise, and hypotension, especially in elderly patients.
- Rare Diagnoses
- Pheochromocytoma: A rare tumor of the adrenal gland that can cause episodic or sustained hypotension, fatigue, and malaise.
- Hemorrhagic Shock: Although rare, hemorrhagic shock can occur in elderly patients due to various reasons such as gastrointestinal bleeding or trauma, leading to hypotension, fatigue, and malaise.
- Amyloidosis: A rare condition characterized by the deposition of abnormal proteins in various organs, including the heart, kidneys, and adrenal glands, leading to hypotension, fatigue, and malaise.