Differential Diagnosis for Shortness of Breath on Exertion and Angina
Single Most Likely Diagnosis
- Coronary Artery Disease (CAD): This is the most likely diagnosis given the symptoms of shortness of breath on exertion and angina. CAD can lead to reduced blood flow to the heart muscle, causing chest pain (angina) and shortness of breath during physical activity due to increased oxygen demand.
Other Likely Diagnoses
- Hypertension: Uncontrolled high blood pressure can lead to heart failure, causing shortness of breath, and can also contribute to the development of angina.
- Heart Failure: Reduced heart function can lead to shortness of breath on exertion and angina due to the heart's inability to meet the body's oxygen demands during physical activity.
- Chronic Obstructive Pulmonary Disease (COPD): Although more commonly associated with chronic cough and sputum production, COPD can cause shortness of breath on exertion. If COPD patients also have cardiovascular risk factors, angina could be a co-existing condition.
Do Not Miss Diagnoses
- Pulmonary Embolism (PE): A life-threatening condition that can cause sudden onset of shortness of breath and chest pain, which might be mistaken for angina. It's crucial to consider PE, especially if there are risk factors such as recent travel, immobility, or family history of clotting disorders.
- Aortic Dissection: A serious condition where there is a tear in the aorta's inner layer, which can cause severe chest pain and shortness of breath. It often presents with a tearing sensation in the chest and can be fatal if not promptly treated.
- Cardiac Tamponade: Fluid accumulation in the sac around the heart can compress the heart, leading to reduced cardiac output, shortness of breath, and potentially angina-like chest pain.
Rare Diagnoses
- Mitral Valve Prolapse: A condition where the two valve flaps of the mitral valve do not close smoothly or evenly but instead bulge (prolapse) upward into the left atrium when the heart contracts. It can lead to shortness of breath and chest pain in some cases.
- Cardiac Sarcoidosis: A rare condition where granulomas form in the heart, potentially leading to heart failure, arrhythmias, and symptoms that could mimic angina and shortness of breath on exertion.
- Anomalous Coronary Artery: A rare congenital condition where a coronary artery arises from an abnormal location, which can lead to angina and shortness of breath due to compression of the artery during exertion.