Differential Diagnosis for 17-Year-Old Female Patient
The patient presents with symptoms of tiredness, lethargy, heart palpitations, chest pain, and breathing difficulties. Here's a categorized differential diagnosis:
- Single Most Likely Diagnosis
- Anxiety Disorder or Panic Attack: The symptoms of heart palpitations, chest pain, feeling of the heart being squeezed, and shortness of breath, especially when triggered by specific movements like bending over or turning the head, are common in anxiety disorders or panic attacks. The feeling of impending doom or about to pass out also aligns with panic attack symptoms.
- Other Likely Diagnoses
- Mitral Valve Prolapse: This condition can cause chest pain, palpitations, and shortness of breath, especially when bending over or changing positions. It's a common cause of these symptoms in young women.
- Hypothyroidism: Although less common, hypothyroidism can cause fatigue, lethargy, and palpitations. Chest pain and shortness of breath can also occur, especially if there's associated pericardial effusion.
- Dehydration or Electrolyte Imbalance: Dehydration or electrolyte imbalances, such as low potassium or magnesium, can cause fatigue, palpitations, and shortness of breath.
- Do Not Miss Diagnoses
- Cardiac Arrhythmias (e.g., Supraventricular Tachycardia): Although less likely, cardiac arrhythmias can cause palpitations, chest pain, and shortness of breath. If missed, they can lead to serious complications.
- Pulmonary Embolism: Although rare in young women without risk factors, pulmonary embolism can cause sudden onset of chest pain, shortness of breath, and palpitations. It's a life-threatening condition that requires immediate attention.
- Cardiac Tamponade: This is a life-threatening condition where fluid accumulates in the pericardial sac, causing cardiac compression. It can cause chest pain, shortness of breath, and palpitations.
- Rare Diagnoses
- Pheochromocytoma: A rare tumor that causes excessive catecholamine production, leading to palpitations, chest pain, and shortness of breath.
- Hyperthyroidism: Although less common, hyperthyroidism can cause palpitations, fatigue, and shortness of breath.
- Cardiomyopathy: A rare condition where the heart muscle becomes weakened or stiff, causing palpitations, chest pain, and shortness of breath.