Differential Diagnosis for Inability to Inspire after Coughing Spell with Persistent Tachycardia

• Single Most Likely Diagnosis
  • Pneumothorax: This condition is highly plausible given the symptoms. A severe coughing spell can lead to a pneumothorax, where air leaks into the space between the lung and chest wall, causing the lung to collapse partially or completely. This would explain the inability to inspire and could also lead to tachycardia due to decreased oxygenation and stress on the body.
• Other Likely Diagnoses
  • Pulmonary Embolism: Although less directly related to coughing, a pulmonary embolism could cause sudden onset of dyspnea (difficulty breathing) and tachycardia. The cough could be unrelated or a symptom of the embolism.
  • Asthma or COPD Exacerbation: Both conditions can cause severe respiratory distress and tachycardia, especially if the coughing spell triggers an exacerbation.
• Do Not Miss Diagnoses
  • Cardiac Tamponade: Although less common, cardiac tamponade is a life-threatening condition where fluid accumulates in the sac around the heart, impeding its ability to pump. It can cause difficulty breathing and tachycardia. The cough could be a trigger or an unrelated symptom.
  • Tension Pneumothorax: A more severe form of pneumothorax, where the air leak continues to fill the chest cavity, increasing pressure and further collapsing the lung. This is a medical emergency requiring immediate intervention.
• Rare Diagnoses
  • Diaphragmatic Hernia: A rare condition where part of the diaphragm ruptures, allowing abdominal organs to move into the chest cavity and potentially causing respiratory distress.
  • Tracheal or Bronchial Rupture: Although rare, a severe cough could potentially lead to a rupture of the trachea or a bronchus, causing severe respiratory distress and potentially life-threatening complications if not promptly treated.