Differential Diagnosis
- Single most likely diagnosis
- Asthma exacerbation: The patient has a history of asthma, and the presence of wheezing over bilateral lungs is a classic symptom of an asthma exacerbation. The unremarkable CBC, CMP, and low troponin and d-dimer levels also support this diagnosis.
- Other Likely diagnoses
- Chronic obstructive pulmonary disease (COPD) exacerbation: Although the patient has a history of asthma, COPD could also be a consideration, especially if the patient has a history of smoking or other risk factors.
- Allergic reaction: The patient's upper airway disease and wheezing could be related to an allergic reaction, which could be causing bronchospasm and wheezing.
- Viral upper respiratory infection: A viral infection could be causing the patient's upper airway disease and wheezing, especially if the patient has a history of recent illness.
- Do Not Miss (ddxs that may not be likely, but would be deadly if missed.)
- Pulmonary embolism (PE): Although the d-dimer is low, a PE could still be present, especially if the patient has a history of risk factors such as recent travel or immobility.
- Cardiac tamponade: The patient's wheezing and shortness of breath could be related to a cardiac tamponade, which would require immediate attention.
- Pneumothorax: A pneumothorax could be causing the patient's wheezing and shortness of breath, and would require immediate attention.
- Rare diagnoses
- Cystic fibrosis: Although rare, cystic fibrosis could be a consideration in a patient with chronic respiratory symptoms and wheezing.
- Bronchiolitis obliterans: This rare condition could be causing the patient's wheezing and shortness of breath, especially if the patient has a history of lung injury or infection.