Differential Diagnosis for Shortness of Breath

Given the patient's presentation of shortness of breath with vitals showing a temperature of 97.7°F, heart rate of 98 bpm, blood pressure of 124/78 mm/Hg, respiratory rate of 20 rpm, and SpO2 of 98%, the following differential diagnoses are considered:

• Single Most Likely Diagnosis
  • Anxiety or Panic Attack: The patient's high heart rate and respiratory rate, despite having a normal oxygen saturation level, could suggest an anxiety or panic attack, especially if there are no other obvious signs of respiratory or cardiac distress.
• Other Likely Diagnoses
  • Asthma: Although the SpO2 is currently normal, asthma could cause shortness of breath, and the diagnosis should be considered, especially if there's a history of asthma or if symptoms worsen.
  • Chronic Obstructive Pulmonary Disease (COPD): Similar to asthma, COPD could be a cause of shortness of breath, particularly in patients with a history of smoking or exposure to lung irritants.
  • Pneumonia: Despite the normal SpO2, pneumonia is a consideration, especially if the patient has recently been exposed to someone with a respiratory infection or has other symptoms such as cough or fever that are not immediately apparent.
• Do Not Miss Diagnoses
  • Pulmonary Embolism (PE): Although less likely given the normal oxygen saturation and lack of other specific symptoms like chest pain or syncope, PE is a potentially life-threatening condition that must be considered, especially if there are risk factors such as recent travel, surgery, or family history of clotting disorders.
  • Cardiac Conditions (e.g., Heart Failure, Myocardial Infarction): Conditions like heart failure or myocardial infarction can cause shortness of breath and are critical to diagnose promptly due to their high morbidity and mortality.
• Rare Diagnoses
  • Pneumothorax: A spontaneous pneumothorax could cause shortness of breath, although it would typically be associated with chest pain and possibly decreased breath sounds on one side, which are not mentioned.
  • Interstitial Lung Disease: This is a broad category of diseases that affect the interstitium of the lung and can cause shortness of breath, but they are less common and typically have a more gradual onset.

Each of these diagnoses should be considered in the context of the patient's full medical history, physical examination, and additional diagnostic tests as necessary.