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Differential Diagnosis for 14yo Female with Episodic Lightheadedness

Single Most Likely Diagnosis

  • Postural Orthostatic Tachycardia Syndrome (POTS): This condition is characterized by a rapid increase in heart rate and other symptoms that occur upon standing, which aligns with the patient's positive orthostatic test and episodic lightheadedness. It is particularly common in adolescent females.

Other Likely Diagnoses

  • Dehydration: This can lead to orthostatic hypotension, causing lightheadedness when standing up. It's a common issue, especially in adolescents who may not drink enough water or lose fluids through physical activity or illness.
  • Anemia: Iron deficiency anemia, for example, can cause symptoms of lightheadedness due to reduced oxygen delivery to tissues. It's a possibility in adolescent females, especially if they have heavy menstrual periods.
  • Hypothyroidism: Although less common, hypothyroidism can cause dizziness and lightheadedness among other symptoms. It's worth considering, especially if other signs of hypothyroidism are present.

Do Not Miss Diagnoses

  • Cardiac Arrhythmias: Conditions like supraventricular tachycardia or other arrhythmias can cause episodic lightheadedness and are critical to diagnose due to their potential to lead to serious complications.
  • Orthostatic Hypotension due to Autonomic Dysfunction: This could be a sign of an underlying neurological condition affecting the autonomic nervous system, such as autonomic dysfunction or early signs of conditions like multiple system atrophy.
  • Pheochromocytoma: A rare tumor of the adrenal gland that can cause episodes of hypertension, tachycardia, and orthostatic hypotension, leading to lightheadedness.

Rare Diagnoses

  • Mitral Valve Prolapse: While often asymptomatic, in some cases, it can lead to symptoms like lightheadedness, especially if there's significant mitral regurgitation.
  • Chiari Malformation: A structural defect in the cerebellum that can cause symptoms due to compression of the brainstem and spinal cord, potentially leading to orthostatic intolerance.
  • Ehlers-Danlos Syndrome: A group of disorders that affect connective tissues supporting the skin, bones, blood vessels, and many other organs and tissues. Some types can lead to autonomic dysfunction and orthostatic intolerance.

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Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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