Differential Diagnosis for 78 yo Female with Chills but no Fever 24 hours after Ablation
- Single most likely diagnosis
- Post-procedural atrial fibrillation or other arrhythmia: The patient recently underwent an ablation, a procedure often used to treat arrhythmias like atrial fibrillation. Chills without fever could be a manifestation of the body's response to the procedure or a sign of an arrhythmia.
- Other Likely diagnoses
- Pericarditis: This is an inflammation of the pericardium, the sac surrounding the heart. It can occur after cardiac procedures like ablation and may present with symptoms such as chills, chest pain, and possibly a pericardial friction rub.
- Pneumonia or atelectasis: Patients who have undergone procedures requiring general anesthesia or deep sedation are at risk for respiratory complications. Chills could be an early sign of infection or a reaction to the anesthesia.
- Reaction to the ablation procedure itself: This could include a response to the catheters, dyes, or other materials used during the procedure.
- Do Not Miss (ddxs that may not be likely, but would be deadly if missed.)
- Pulmonary embolism: Although less common, pulmonary embolism is a potentially life-threatening condition that could present with chills, among other symptoms, especially in a post-procedural setting where immobility may increase the risk of venous thromboembolism.
- Cardiac tamponade: A serious complication that can arise after cardiac procedures, characterized by fluid accumulation in the pericardial space leading to compression of the heart. It is a medical emergency.
- Sepsis: Although the patient does not have a fever, sepsis can present atypically in elderly patients, and chills could be an early sign of a systemic infection.
- Rare diagnoses
- Endocarditis: An infection of the heart valves, which is a rare but serious complication of cardiac procedures. It might present with non-specific symptoms such as chills.
- Air embolism: A rare but potentially fatal complication of procedures involving catheterization, where air enters the vascular system.
- Vasovagal reaction: A reaction that might occur in response to the procedure, potentially causing symptoms like chills due to vagal nerve stimulation.