Differential Diagnosis for 43 yo F with HTN, Decreased Running Pace, and Minor Chest Pain
- Single Most Likely Diagnosis
- Hypertensive Heart Disease: The patient's recent development of hypertension, decreased running pace, and episode of minor chest pain at rest suggest that her hypertension may be affecting her heart, leading to decreased cardiac output and potentially causing her symptoms.
- Other Likely Diagnoses
- Coronary Artery Disease (CAD): Although the patient is relatively young, her recent onset of hypertension and episode of chest pain raise the possibility of CAD, especially if she has other risk factors such as high cholesterol, diabetes, or a family history of CAD.
- Cardiomyopathy: The patient's decreased running pace and episode of chest pain could be indicative of a cardiomyopathy, such as hypertrophic cardiomyopathy or dilated cardiomyopathy, which can be caused by hypertension or other factors.
- Anemia or Iron Deficiency: A decrease in running pace can be caused by anemia or iron deficiency, which can also cause fatigue, shortness of breath, and chest pain.
- Do Not Miss Diagnoses
- Acute Coronary Syndrome (ACS): Although the patient's episode of chest pain was minor, it is essential to consider the possibility of ACS, including myocardial infarction or unstable angina, as these conditions can be life-threatening if not promptly diagnosed and treated.
- Pulmonary Embolism (PE): The patient's episode of chest pain at rest and decreased running pace could be indicative of a PE, which can be fatal if not promptly diagnosed and treated.
- Aortic Dissection: The patient's hypertension and episode of chest pain raise the possibility of an aortic dissection, which is a life-threatening condition that requires immediate medical attention.
- Rare Diagnoses
- Arrhythmogenic Right Ventricular Cardiomyopathy (ARVC): This rare condition can cause decreased running pace, chest pain, and palpitations, but it is relatively rare and typically affects younger individuals.
- Cardiac Sarcoidosis: This rare condition can cause decreased running pace, chest pain, and shortness of breath, but it is relatively rare and typically affects individuals with a history of sarcoidosis.
- Mitral Valve Prolapse: This condition can cause chest pain, palpitations, and decreased running pace, but it is relatively rare and typically affects individuals with a history of mitral valve problems.