Differential Diagnosis for 82 year old female with A Fib RVR, Hyperventilating, and Extensive Cardiac History
- Single most likely diagnosis:
- Atrial Fibrillation with Rapid Ventricular Response (AFib RVR) exacerbation: This is the most likely diagnosis given the patient's presentation of A Fib RVR and extensive cardiac history. The hyperventilation could be a response to the decreased cardiac output and increased sympathetic tone associated with AFib RVR.
- Other Likely diagnoses:
- Pulmonary Embolism (PE): The patient's hyperventilation and extensive cardiac history increase the suspicion for a PE, which can cause A Fib RVR.
- Acute Coronary Syndrome (ACS): Given the patient's extensive cardiac history, ACS should be considered, as it can cause A Fib RVR and hyperventilation.
- Heart Failure (HF) exacerbation: The patient's A Fib RVR and hyperventilation could be indicative of a HF exacerbation, especially with a history of cardiac disease.
- Do Not Miss diagnoses:
- Cardiac Tamponade: Although less likely, cardiac tamponade is a life-threatening condition that can cause A Fib RVR and hyperventilation, and it is crucial to consider in patients with extensive cardiac history.
- Aortic Dissection: This is another life-threatening condition that can cause A Fib RVR and hyperventilation, and it should not be missed, especially in patients with a history of hypertension and cardiac disease.
- Rare diagnoses:
- Thyrotoxicosis: Although rare, thyrotoxicosis can cause A Fib RVR and hyperventilation, and it should be considered in the differential diagnosis, especially if the patient has a history of thyroid disease.
- Pheochromocytoma: This rare tumor can cause A Fib RVR and hyperventilation due to excessive catecholamine release, and it should be considered in patients with unexplained hypertension and cardiac disease.