Differential Diagnosis for 28 yo G1 P0 with HA, Dizziness, Lightheadedness, and Blurry Vision
- Single Most Likely Diagnosis
- Hypertension: The patient's blood pressure is elevated at 146/82, which could be causing her symptoms of headache (HA), dizziness, lightheadedness, and blurry vision. The heart rate is also slightly elevated at 110, which could be a response to the hypertension or another underlying issue.
- Other Likely Diagnoses
- Dehydration: Given the symptoms of dizziness, lightheadedness, and blurry vision, dehydration is a possible cause, especially if the patient has not been drinking enough fluids or has been experiencing excessive fluid loss.
- Anemia: In a pregnant woman (G1 P0 indicates she is pregnant), anemia could be a cause of these symptoms due to increased blood volume and demand for iron.
- Pregnancy-induced Hypertension: Although the patient's blood pressure is not extremely high, pregnancy-induced hypertension (PIH) could be a consideration, especially if this is a new onset of hypertension.
- Do Not Miss Diagnoses
- Preeclampsia: A potentially life-threatening condition characterized by high blood pressure and often accompanied by protein in the urine, preeclampsia is a critical diagnosis not to miss in pregnant women, especially with symptoms like headache and vision changes.
- Stroke or TIA: Although less likely given the patient's age and presentation, a stroke or transient ischemic attack (TIA) could cause sudden onset of headache, dizziness, and vision changes and must be considered due to the potential for severe outcomes.
- Eclampsia: If the patient were to seize, eclampsia would be a consideration, but given the current symptoms, it's less likely unless the condition rapidly progresses.
- Rare Diagnoses
- Posterior Reversible Encephalopathy Syndrome (PRES): A rare condition associated with high blood pressure, often seen in pregnancy, that can cause headache, vision changes, and seizures.
- Migraine with Aura: Although migraines are common, a migraine with aura (which can include visual disturbances) could be considered, especially if the patient has a history of migraines. However, the presence of hypertension and pregnancy complicates this diagnosis.