Differential Diagnosis for Pregnant Patient with Acute Episode of Tachycardia, Dyspnea, and Neurological Symptoms

• Single Most Likely Diagnosis
  • Panic Attack or Anxiety Disorder: The symptoms of tachycardia, dyspnea, paresthesias, and severe headache could be indicative of a panic attack, especially given the acute onset and the specific triggers (e.g., the anatomy scan, which can be a source of significant stress for pregnant patients).
• Other Likely Diagnoses
  • Pregnancy-Induced Hypertension (PIH) or Preeclampsia: Although less likely given the specific constellation of symptoms, PIH or preeclampsia could present with severe headaches and potentially some neurological symptoms. However, the presence of tachycardia and dyspnea would be less typical as initial symptoms.
  • Migraine: The severe headache and neurological symptoms (paresthesias, shooting pain) could suggest a migraine, which can be triggered by stress and is common in women of childbearing age.
• Do Not Miss Diagnoses
  • Pulmonary Embolism (PE): Although less common, PE is a critical diagnosis to consider in pregnant patients presenting with acute dyspnea and tachycardia, as it can be life-threatening if not promptly diagnosed and treated.
  • Stroke or Transient Ischemic Attack (TIA): The neurological symptoms (paresthesias, severe headache) could indicate a stroke or TIA, which are emergencies requiring immediate attention.
  • Cardiac Conditions (e.g., Cardiomyopathy, Arrhythmias): Pregnant patients can experience cardiac decompensation or arrhythmias due to the physiological changes of pregnancy, which could present with tachycardia and dyspnea.
• Rare Diagnoses
  • Multiple Sclerosis (MS) or Acute Demyelinating Neuropathy: The neurological symptoms could suggest an MS relapse or an acute demyelinating event, although these would be less likely given the acute onset and specific triggers.
  • Eclampsia: Although a severe headache and neurological symptoms could be part of eclampsia, the absence of seizures and the specific pattern of symptoms make this less likely.
  • Cervical or Lumbar Disc Herniation: The shooting pain in the lower back and hip joints could suggest a disc herniation, but this would not typically cause systemic symptoms like tachycardia and dyspnea.