Differential Diagnosis for a 25-year-old G1P0 13 weeks pregnant female

Single most likely diagnosis

• Preeclampsia: Given the patient's symptoms of blurry vision, arm tingling, dizziness, and headache, along with a history of hypertension, preeclampsia is a strong consideration. Preeclampsia is a condition characterized by high blood pressure and often protein in the urine, occurring after the 20th week of pregnancy, but it can be considered in patients with a history of hypertension even before 20 weeks.

Other Likely diagnoses

• Migraine: The symptoms of blurry vision, arm tingling, and headache could also suggest a migraine, especially if the patient has a history of migraines. Pregnancy can affect migraine frequency and severity.
• Anxiety or Panic Attack: Dizziness, arm tingling, and headache could also be symptoms of an anxiety or panic attack, which can be exacerbated by the stress of pregnancy.
• Hypertensive Crisis: Given the patient's history of hypertension, a hypertensive crisis could explain the symptoms, especially if blood pressure is significantly elevated.

Do Not Miss (ddxs that may not be likely, but would be deadly if missed)

• Stroke or Transient Ischemic Attack (TIA): Although less common in young individuals, the symptoms of arm tingling, dizziness, and headache could indicate a stroke or TIA, which requires immediate medical attention.
• Eclampsia: If the patient were to seize, eclampsia would be a consideration, although it typically occurs after preeclampsia has been diagnosed.
• Posterior Reversible Encephalopathy Syndrome (PRES): This is a rare condition associated with high blood pressure and can cause symptoms similar to those described, including visual disturbances and headache.

Rare diagnoses

• Multiple Sclerosis: Although rare, multiple sclerosis could explain some of the neurological symptoms such as arm tingling and vision disturbances, but it would not typically cause hypertension.
• Thyroid Storm: In the context of pregnancy, thyroid storm could cause hypertension, headaches, and other systemic symptoms, but it is relatively rare and would typically be associated with known thyroid disease.
• Cerebral Venous Thrombosis: This is a rare condition that could cause headache and other neurological symptoms, but it is less likely without other predisposing factors such as thrombophilia or dehydration.