Differential Diagnosis

The patient presents with a 10-pound weight gain in one week, tachycardia, tachypnea, hypertension, and chest pain. Here is a differential diagnosis organized into categories:

• Single Most Likely Diagnosis

  • Congestive Heart Failure (CHF): The patient's symptoms of weight gain, tachycardia, tachypnea, and chest pain are consistent with CHF. The weight gain is likely due to fluid retention, which is a hallmark of CHF.

• Other Likely Diagnoses

  • Nephrotic Syndrome: The patient's weight gain and hypertension could be indicative of nephrotic syndrome, which is characterized by heavy proteinuria, hypoalbuminemia, and edema.
  • Chronic Kidney Disease (CKD): The patient's hypertension and weight gain could be related to CKD, which can cause fluid retention and electrolyte imbalances.
  • Acute Kidney Injury (AKI): The patient's weight gain and hypertension could be indicative of AKI, which can cause fluid retention and electrolyte imbalances.

• Do Not Miss Diagnoses

  • Pulmonary Embolism (PE): Although less likely, PE is a life-threatening condition that can present with tachycardia, tachypnea, and chest pain. The patient's pulse oximetry reading of 94% is slightly low, which could be indicative of a PE.
  • Aortic Dissection: The patient's hypertension and chest pain could be indicative of an aortic dissection, which is a life-threatening condition that requires immediate attention.
  • Cardiac Tamponade: The patient's tachycardia, tachypnea, and chest pain could be indicative of cardiac tamponade, which is a life-threatening condition that requires immediate attention.

• Rare Diagnoses

  • Thyroid Storm: The patient's tachycardia, tachypnea, and hypertension could be indicative of a thyroid storm, which is a rare but life-threatening condition.
  • Pheochromocytoma: The patient's hypertension and tachycardia could be indicative of a pheochromocytoma, which is a rare tumor that can cause episodic hypertension and tachycardia.