Medical Advisory BoardAll articles are reviewed for accuracy by our Medical Advisory Board
Educational purpose only • Exercise caution as content is pending human review
Article Review Status
Submitted
Under Review
Approved

Last updated: September 11, 2025 • View editorial policy

Personalize

Help us tailor your experience

Which best describes you? Your choice helps us use language that's most understandable for you.

Differential Diagnosis for 25-year-old Male with Severe Shortness of Breath and Pleuritic Chest Pain

  • Single most likely diagnosis:
    • Pulmonary Embolism (PE): The patient's recent long-haul flight increases the risk of deep vein thrombosis (DVT), which can lead to PE. The symptoms of severe shortness of breath, pleuritic chest pain, low-grade fever, and low blood pressure are consistent with a large PE. The patient's leg pain, attributed to stress and long work hours, could be a DVT.
  • Other Likely diagnoses:
    • Pneumonia: The patient's symptoms of shortness of breath, pleuritic chest pain, and low-grade fever could be indicative of pneumonia. However, the recent long-haul flight and leg pain make PE a more likely diagnosis.
    • Acute Coronary Syndrome (ACS): Although less common in a 25-year-old, ACS should be considered, especially with the patient's symptoms of chest pain and shortness of breath. However, the pleuritic nature of the chest pain and the patient's age make this less likely.
  • Do Not Miss diagnoses:
    • Cardiac Tamponade: This is a life-threatening condition that can cause shortness of breath, chest pain, and hypotension. Although less likely, it is crucial to consider and rule out with echocardiography.
    • Pneumothorax: A spontaneous pneumothorax can cause severe shortness of breath, pleuritic chest pain, and hypotension. This diagnosis should be considered, especially in a tall, thin male.
    • Sepsis: The patient's symptoms of shortness of breath, chest pain, and hypotension could be indicative of sepsis, especially with a possible source of infection (e.g., pneumonia). It is essential to consider and rule out sepsis.
  • Rare diagnoses:
    • Pulmonary Arterial Hypertension (PAH): This is a rare condition that can cause shortness of breath, chest pain, and hypotension. However, it is less likely in this scenario, given the patient's age and recent long-haul flight.
    • Vasculitis (e.g., Wegener's granulomatosis): This is a rare condition that can cause shortness of breath, chest pain, and hypotension. However, it is less likely in this scenario, given the patient's age and lack of other systemic symptoms.

Related Questions

What are the causes of low cortisol levels?
Does reversal and discontinuation of a blood thinner (anticoagulant) affect life expectancy in a patient with intraparenchymal hemorrhage and small ventricular extension without hydrocephalus or significant mass effect?
What is the recommended dosage and treatment plan for Fexofenadine (Allegra) in patients with allergic reactions?
What is the increase in serum magnesium concentration after administering 1 gram of intravenous (IV) magnesium?
Can you take amitriptyline with Cymbalta (duloxetine)?

Professional Medical Disclaimer

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.

Have a follow-up question?

Our Medical A.I. is used by practicing medical doctors at top research institutions around the world. Ask any follow up question and get world-class guideline-backed answers instantly.

Ask Question