What is the diagnosis for a 57-year-old female patient with a history of hypertension, acute myeloid leukemia (AML) treated with cytarabine (Cytosine Arabinoside) and daunorubicin, hypothyroidism, and a heart murmur, presenting with progressive chest pressure, exacerbated by physical activity, and associated with elevated heart rate (tachycardia) and extreme fatigue?

Differential Diagnosis for Ms. Glenda Lamont

Single Most Likely Diagnosis

• Stable Angina: This is the most likely diagnosis given Ms. Lamont's symptoms of chest pressure that worsen with exertion and improve with rest. Her history of hypertension and smoking also increase her risk for coronary artery disease.

Other Likely Diagnoses

• Heart Failure: Ms. Lamont's symptoms of extreme fatigue and chest pressure, especially with exertion, could be indicative of heart failure. Her history of a heart murmur and hypertension also support this diagnosis.
• Anxiety or Panic Disorder: Ms. Lamont's description of her heart "beating out of her chest" and feeling anxious could suggest an anxiety or panic disorder, which could be contributing to her chest pressure symptoms.
• Hypothyroidism: Although Ms. Lamont is being treated for hypothyroidism, her symptoms of fatigue and chest pressure could be indicative of inadequate treatment or worsening hypothyroidism.

Do Not Miss Diagnoses

• Acute Coronary Syndrome (ACS): Although Ms. Lamont's symptoms have been ongoing for months, it is essential to rule out ACS, as it can present atypically in women and can be life-threatening if missed.
• Pulmonary Embolism (PE): Ms. Lamont's history of cancer and chemotherapy increases her risk for PE, which can present with chest pressure and shortness of breath.
• Cardiac Tamponade: Ms. Lamont's history of cancer and chemotherapy also increases her risk for cardiac tamponade, which can present with chest pressure and shortness of breath.
• Aortic Dissection: Although less likely, aortic dissection is a life-threatening condition that can present with chest pressure and must be ruled out.

Rare Diagnoses

• Cardiac Sarcoidosis: Ms. Lamont's history of cancer and chemotherapy increases her risk for cardiac sarcoidosis, which can present with chest pressure and arrhythmias.
• Amyloidosis: Ms. Lamont's history of cancer and chemotherapy also increases her risk for amyloidosis, which can present with chest pressure and shortness of breath.
• Cardiac Hemochromatosis: Although rare, cardiac hemochromatosis can present with chest pressure and heart failure, and must be considered in patients with a history of cancer and chemotherapy.