Differential Diagnosis for Palpitations
The patient's symptoms of palpitations, chest tightness, lightheadedness, and anxiety, which resolved spontaneously, suggest a cardiac or anxiety-related etiology. The following differential diagnoses are considered:
- Single most likely diagnosis
- Panic Attack: The patient's symptoms of palpitations, chest tightness, lightheadedness, and anxiety are classic for a panic attack. The fact that her symptoms resolved spontaneously and she had a similar episode in the past further supports this diagnosis.
- Other Likely diagnoses
- Supraventricular Tachycardia (SVT): Although the patient's EKG was normal, SVT can cause palpitations and chest tightness. The fact that her symptoms resolved spontaneously is consistent with SVT.
- Anxiety Disorder: The patient's symptoms of anxiety and panic attacks suggest an underlying anxiety disorder.
- Mitral Valve Prolapse: This condition can cause palpitations, chest tightness, and anxiety, especially in young women.
- Do Not Miss (ddxs that may not be likely, but would be deadly if missed.)
- Cardiac Arrhythmias (e.g., Ventricular Tachycardia): Although unlikely, cardiac arrhythmias can be life-threatening and must be considered in the differential diagnosis.
- Pulmonary Embolism: Although the patient's symptoms do not strongly suggest pulmonary embolism, it is a potentially life-threatening condition that must be considered.
- Hypertrophic Cardiomyopathy: This condition can cause palpitations, chest tightness, and sudden death, especially in young athletes.
- Rare diagnoses
- Pheochromocytoma: This rare tumor can cause episodic palpitations, chest tightness, and anxiety due to catecholamine release.
- Thyroid Storm: Although rare, thyroid storm can cause palpitations, chest tightness, and anxiety, especially in patients with a history of thyroid disease.
- Catecholaminergic Polymorphic Ventricular Tachycardia (CPVT): This rare genetic disorder can cause palpitations, chest tightness, and sudden death, especially in young patients.