Differential Diagnosis for 42-year-old Male with Chest Pains, Palpitations, Headache, and Tingling Forearms
Single Most Likely Diagnosis
- Hypertension: Given the ECG findings of suspected ventricular hypertrophy and the patient's symptoms of chest pain, palpitations, and headache, hypertension is a strong candidate. It can lead to ventricular hypertrophy and cause the described symptoms.
Other Likely Diagnoses
- Anxiety Disorder: The symptoms of palpitations, chest pain, and tingling sensations can also be associated with anxiety disorders. The absence of significant ECG findings pointing towards a STEMI or STEMI equivalent makes this a plausible diagnosis.
- Hyperthyroidism: This condition can cause palpitations, chest pain, and tingling sensations due to nerve excitability. It can also lead to atrial enlargement and ventricular hypertrophy over time.
- Mitral Valve Prolapse: This condition can cause chest pain, palpitations, and sometimes tingling sensations in the arms. It may lead to mitral regurgitation, which can result in atrial enlargement.
Do Not Miss Diagnoses
- Aortic Dissection: Although less likely given the ECG findings, aortic dissection is a life-threatening condition that can present with chest pain and must be considered, especially if the pain is severe and tearing in nature.
- Pulmonary Embolism: This condition can cause chest pain, palpitations, and sometimes headache. It's crucial to consider, especially if there are risk factors for thromboembolism.
- Cardiac Sarcoidosis: This can lead to ventricular hypertrophy, atrial enlargement, and conduction abnormalities, including incomplete RBBB. It's a less common condition but can be life-threatening if not diagnosed.
Rare Diagnoses
- Fabry Disease: A genetic disorder that can lead to ventricular hypertrophy and cause symptoms like chest pain, palpitations, and tingling sensations due to small fiber neuropathy.
- Arrhythmogenic Right Ventricular Cardiomyopathy (ARVC): A rare condition that affects the right ventricle, leading to arrhythmias and potentially palpitations and chest pain.
- Cardiac Amyloidosis: Can cause ventricular hypertrophy and lead to symptoms like chest pain and palpitations due to restrictive cardiomyopathy.