Abstract
On the differential diagnosis of the presented medical history, several medical conditions relating to the cardiovascular, digestive, respiratory, muscle and bone systems can be linked with those medical signs and symptoms. Exploring the several causes of the chest pain, all the above systems listed are likely to be a cause. However, the history of hypertension eliminates those that are related to the digestive, muscular and bony etiologies. Further reviewing the role of high cholesterol, palor and increased sweating, a conclusion of heart attack or condition is made. Further investigations might need to be conducted to make the definitive diagnosis. Once this is done, treatment can then be instituted so as to help this patient in need.
Introduction
Differential diagnosis is a process of elimination that helps achieve the right diagnosis. This case study is about a 57yr male patient who is complaining of chest pain that started an hour ago and is 8/10 on a pain scale. Your patient is pale and diaphoretic. He has a history or pneumonia, Hypertension, High Cholesterol. He is taking a “water pill” and is not allergic to any medications. He is unable to stand up without passing out.
Note on differential diagnosis
Taking a look at this patient, the signs and symptoms can be linked to different etiological factors. Taking a chest pain as a major entity, there are several causes that are associated with these symptoms. Chest pain can be associated with the digestive causes, muscle and bone, lung related and heart related causes. Heart related causes are: heart attack, angina, aortic dissection, and pericarditis. Digestive causes are heartburn, swallowing disorders and gallbladder problems. Muscle and bone causes are costonchodritis, sore muscles, and injured ribs. Lung related causes; pulmonary embolism, pleurisy, collapsed lungs, and pulmonary hypertension.
The commonest causes of the chest pain are those that are related to the heart disorders such as the angina, myocardial infarction (heart attack), myocarditis, pericarditis, hypertrophic cardiomyopathy, mitral valve prolapse and coronary artery dissection. Chest pain from angina seems to be commonest while sweating; nausea and severe weakness are features that usually accompany the chest pain of myocardial infarction. Some of the common conditions that cause increase sweating are the heart disease, lung diseases, diabetes and shock.
If we look critically at the listed signs and symptoms relating to this patient, we can easily deduce that the condition is that which relates to the heart diseases. Taking a critical look, the patient is identified to always pass out whenever he stands up; there is a history of hypertension, chest pain, diaphoretic status and pale. Other status that might also point towards the cardiovascular or heart disorders is the high cholesterol level which has implication on people health status. In most situations, the common related causes that are linked to the heart diseases is the problem with the blood flow through the blood vessels which either poor supply or affect the heart muscle cells.
All these conditions are linked with the heart pain which is either in the form of crushing pain or angina. These types of pain are usually influenced by the rest. In case of the myocarditis, the problem is usually not related to the blockage which is seen in the case of myocardial infarction. In myocarditis, the problem is related to inflammation and in this situation, symptoms are more of feverish and fatigue, although there is also chest pain. Each of the symptoms of the heart conditions are usually found to be associated with a certain type of specific symptoms that could help in making a case diagnosis. Most of those conditions with chest pain relating to the lung usually have one form of difficulty in breathing or cough.
The age of the patient, the hypertensive and high cholesterol factors placed the patient at an increased risks of developing myocardial infarction considering the pathophysiology of the condition. A heart attack is usually caused by disturbance or blockage of flow of blood from the source to destination along the coronary arteries. This place the myocardium at a very high risk of damage or death simply because of the shortage of the oxygen circulation. The presence of high cholesterol usually causes plaque which is one major factor that causes this obstruction in blood flow.
Conclusion
Information provided by the patient has clearly shown condition that is caused by several organ systems such as the cardiovascular or digestive system. However, a clearly permutation of the information relating to the signs and symptoms shows that this disease states relates to the heart. The commonest type of heart condition that usually caused this type of chest pain is the myocardial infarction which can relates to hypertension, high cholesterol and increase sweating.
References
Mayoclinic, (2013). Chest Pain. Causes.
Retrieved 27 November, 2013 from http://www.mayoclinic.com/health/chest-pain/DS00016/DSECTION=causes
NIH, (2013). Pneumonia-adults (Community acquired). MedlinePlus.
Retrieved 27 November, 2013 from http://www.nlm.nih.gov/medlineplus/ency/article/000145.htm
WebMD (2013). What's causing my chest pain. Pain Management health center.
Retrieved 28 November, 2013 from http://www.webmd.com/pain-management/guide/whats-causing-my-chest-pain
