Differential Diagnosis

The patient's symptoms of palpitations and lightheadedness when stressed suggest a range of possible diagnoses. Here is a categorized list of differential diagnoses:

• Single most likely diagnosis
  • Anxiety Disorder: The patient's symptoms of palpitations and lightheadedness when stressed are classic symptoms of an anxiety disorder, such as panic disorder or generalized anxiety disorder. The physical symptoms are likely a manifestation of the patient's anxiety.
• Other Likely diagnoses
  • Hyperventilation Syndrome: The patient's symptoms of lightheadedness and palpitations could be caused by hyperventilation, which is often triggered by stress or anxiety.
  • Mitral Valve Prolapse: This condition can cause palpitations, lightheadedness, and anxiety-like symptoms, especially when stressed.
  • Hyperthyroidism: An overactive thyroid gland can cause palpitations, lightheadedness, and anxiety-like symptoms.
• Do Not Miss (ddxs that may not be likely, but would be deadly if missed.)
  • Cardiac Arrhythmia: Although less likely, a cardiac arrhythmia such as atrial fibrillation or supraventricular tachycardia could cause palpitations and lightheadedness, and would be a medical emergency if not promptly treated.
  • Pulmonary Embolism: A pulmonary embolism could cause sudden onset of palpitations and lightheadedness, especially if the patient has a history of deep vein thrombosis or other risk factors.
  • Cardiac Tamponade: Although rare, cardiac tamponade could cause palpitations and lightheadedness, and would be a medical emergency if not promptly treated.
• Rare diagnoses
  • Pheochromocytoma: A rare tumor of the adrenal gland that can cause episodic palpitations, lightheadedness, and anxiety-like symptoms.
  • Postural Orthostatic Tachycardia Syndrome (POTS): A rare condition characterized by a rapid heart rate and other symptoms that occur upon standing, which could be exacerbated by stress.