Differential Diagnosis
- Single most likely diagnosis
- Pulmonary Embolism: This condition is highly plausible given the mention of potential secondary effects from pulmonary disease and the consideration of an old anterior infarct. Pulmonary embolism can lead to acute right ventricular strain, which might mimic or be associated with the symptoms and signs of an old infarct.
- Other Likely diagnoses
- Chronic Obstructive Pulmonary Disease (COPD) Exacerbation: Given the reference to pulmonary disease, an exacerbation of COPD could lead to significant respiratory distress and might be considered in the differential, especially if there's a history of COPD.
- Pneumonia: As a common pulmonary condition, pneumonia could lead to significant illness and might be associated with cardiac complications, including arrhythmias or strain, potentially mimicking or complicating an old infarct.
- Do Not Miss (ddxs that may not be likely, but would be deadly if missed.)
- Aortic Dissection: Although less common, aortic dissection is a life-threatening condition that could present with chest pain and might be associated with or mimic the symptoms of an old infarct, especially if the dissection involves the coronary arteries.
- Cardiac Tamponade: This is a life-threatening condition that could arise from various causes, including pulmonary disease indirectly (through metastatic disease, for example) or directly from cardiac conditions. It requires immediate recognition and treatment.
- Rare diagnoses
- Pulmonary Arteriovenous Malformation: A rare condition that could lead to pulmonary symptoms and potentially to cardiac issues due to the shunting of blood.
- Sarcoidosis: A systemic disease that can affect both the lungs and the heart, potentially leading to symptoms that could be confused with those of an old infarct or pulmonary disease.