Differential Diagnosis for Right Axis Deviation on EKG in a 22-year-old Male with Dizziness after Dog Bite
Single Most Likely Diagnosis
- Normal Variant: Right axis deviation can be a normal variant in young adults, especially if the EKG is otherwise normal. The dizziness could be unrelated to the EKG finding, possibly due to anxiety or a vasovagal response after the dog bite.
Other Likely Diagnoses
- Dehydration or Electrolyte Imbalance: After a dog bite, the patient may have experienced stress, pain, or anxiety, leading to dehydration or electrolyte imbalances, which can cause dizziness and EKG changes, including right axis deviation.
- Anxiety or Panic Attack: The stress of the dog bite could trigger an anxiety or panic attack, leading to dizziness and potentially causing EKG changes, including right axis deviation, due to hyperventilation or other mechanisms.
Do Not Miss Diagnoses
- Rabies or Other Infections: Although rare, rabies or other infections transmitted through the dog bite could lead to neurological symptoms, including dizziness, and potentially affect the heart, causing EKG abnormalities.
- Cardiac Contusion or Trauma: If the dog bite was severe or if the patient experienced trauma during the incident, cardiac contusion or other cardiac injuries could occur, leading to EKG changes and dizziness.
- Hypovolemia or Blood Loss: Significant blood loss or hypovolemia due to the dog bite could cause dizziness and lead to EKG changes, including right axis deviation, due to decreased cardiac output.
Rare Diagnoses
- Arrhythmogenic Right Ventricular Cardiomyopathy (ARVC): A rare genetic disorder that affects the right ventricle, potentially causing right axis deviation on EKG and symptoms like dizziness, especially during or after physical stress or trauma.
- Brugada Syndrome: A rare genetic disorder that can cause right axis deviation and other EKG abnormalities, potentially leading to life-threatening arrhythmias, especially in young adults.
- Pulmonary Embolism: Although rare in young adults without risk factors, a pulmonary embolism could cause dizziness and EKG changes, including right axis deviation, especially if the patient has been immobile or has other risk factors.