Differential Diagnosis
- Single most likely diagnosis
- Congestive Heart Failure (CHF): The patient's symptoms of shortness of breath (SOB) and abdominal distention, combined with a history of diastolic dysfunction, suggest CHF as the most likely diagnosis. The ejection fraction (EF) of 63% is within the normal range, but diastolic dysfunction can still lead to heart failure symptoms.
- Other Likely diagnoses
- Liver disease (e.g., cirrhosis): Abdominal distention could be due to ascites, which is often associated with liver disease. The patient's SOB could be related to hepatopulmonary syndrome or other complications of liver disease.
- Chronic Obstructive Pulmonary Disease (COPD): Increasing SOB could be a symptom of COPD, especially if the patient has a history of smoking or other risk factors.
- Gastrointestinal disorders (e.g., irritable bowel syndrome, inflammatory bowel disease): Abdominal distention and SOB could be related to gastrointestinal disorders, especially if the patient has a history of abdominal symptoms.
- Do Not Miss (ddxs that may not be likely, but would be deadly if missed.)
- Cardiac tamponade: Although less likely, cardiac tamponade is a life-threatening condition that can cause SOB and abdominal distention due to increased pressure in the pericardial space.
- Pulmonary embolism: A pulmonary embolism can cause sudden onset of SOB and is a potentially life-threatening condition that requires prompt diagnosis and treatment.
- Constrictive pericarditis: This condition can cause abdominal distention and SOB due to impaired diastolic filling of the heart.
- Rare diagnoses
- Restrictive cardiomyopathy: This condition can cause diastolic dysfunction and heart failure symptoms, but it is less common than other forms of cardiomyopathy.
- Amyloidosis: This condition can cause restrictive cardiomyopathy and heart failure symptoms, but it is relatively rare.
- Sarcoidosis: This condition can cause cardiac and pulmonary symptoms, including SOB and abdominal distention, but it is relatively rare.