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Differential Diagnosis

  • Single most likely diagnosis
    • Pericarditis: The patient's symptoms of sharp, stabbing chest pain that worsens with deep inspiration and improves when sitting up and leaning forward are classic for pericarditis. The ECG findings, although not described, typically show diffuse ST-segment elevation in pericarditis.
  • Other Likely diagnoses
    • Acute anteroseptal myocardial infarction: Although the pain description is not typical for myocardial infarction, the ECG could potentially show changes consistent with an anteroseptal MI, such as ST-segment elevation in leads V1-V4.
    • Inferior wall myocardial infarction: The ECG might show changes in the inferior leads (II, III, aVF), and while the pain description is not classic, it's possible in the context of an inferior wall MI.
  • Do Not Miss (ddxs that may not be likely, but would be deadly if missed.)
    • Pulmonary embolism: Although the symptoms don't strongly suggest pulmonary embolism, it's a potentially life-threatening condition that can cause chest pain and must be considered, especially if there are risk factors or other suggestive symptoms.
    • Aortic dissection: This is a medical emergency that can cause severe, tearing chest pain. While the description doesn't perfectly match, any possibility of aortic dissection must be promptly evaluated and ruled out.
  • Rare diagnoses
    • Posterior wall myocardial infarction: This would be less common and might present with ST-segment elevation in posterior leads (V7-V9), but the clinical presentation described doesn't strongly suggest this diagnosis.
    • Lateral wall myocardial infarction: While possible, the symptoms and likely ECG findings (ST-segment elevation in leads I, aVL, V5, V6) don't align closely with the description provided, making it a less likely consideration in this context.

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This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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