Differential Diagnosis for DEC Challenge

• Single most likely diagnosis:
  • Pulmonary Embolism (PE) - This is often considered in the context of a DEC (Dyspnea, Edema, Chest pain) challenge due to its acute presentation and the combination of symptoms that can include sudden onset dyspnea, chest pain (especially if pleuritic), and edema (if associated with deep vein thrombosis or right heart strain).
• Other Likely diagnoses:
  • Acute Coronary Syndrome (ACS) - Presents with chest pain and can have associated dyspnea and edema if there is significant left ventricular dysfunction.
  • Pneumonia - Can cause dyspnea, chest pain (especially if pleuritic), and in severe cases, lead to respiratory failure and edema due to hypoxia and fluid overload.
  • Cardiac Tamponade - Presents with dyspnea, chest pain, and can have peripheral edema due to decreased cardiac output.
• Do Not Miss diagnoses:
  • Aortic Dissection - A life-threatening condition that presents with severe chest pain and can have associated dyspnea and edema due to aortic regurgitation or tamponade.
  • Tension Pneumothorax - Requires immediate recognition and treatment, presenting with severe dyspnea, chest pain, and can lead to edema due to decreased venous return.
  • Pulmonary Hypertension Crisis - A severe increase in pulmonary artery pressure can lead to right heart failure, presenting with dyspnea, chest pain, and peripheral edema.
• Rare diagnoses:
  • Pulmonary Arteriovenous Malformation (PAVM) - Rare and can present with dyspnea and chest pain due to right-to-left shunt, potentially leading to edema if significant.
  • Lymphangitic Carcinomatosis - A rare condition where metastatic cancer invades the lymphatic vessels of the lung, leading to dyspnea, chest pain, and potentially edema due to lymphatic obstruction.