Question

A 35-year-old patient complains of shortness of breath. He is conscious and alert and is able to speak in complete sentences, although with slight difficulty. Assessment reveals diffuse wheezing to auscultation, a respiratory rate of 24 breaths/min, a heart rate of 110 beats/min, and an oxygen saturation of 96. What is the most likely diagnosis for this patient?

1) Asthma
2) Pneumonia
3) Chronic obstructive pulmonary disease (COPD)
4) Pulmonary embolism

Answer 1

A 35-year-old patient with shortness of breath, slightly elevated heart rate, and oxygen saturation of 96 with audible wheezing is most likely experiencing an asthma attack. This diagnosis is supported by the acute nature of symptoms and absence of other significant signs like fever or productive cough that are associated with infections or chronic conditions like COPD.

Step-by-step explanation:

Most Likely Diagnosis for the Patient with Respiratory Symptoms

The case of a 35-year-old patient with difficulty speaking in complete sentences, a respiratory rate of 24 breaths/min, heart rate of 110 beats/min, and an oxygen saturation of 96, accompanied by diffuse wheezing suggests the most likely diagnosis is asthma. Asthma is characterized by episodes of airflow obstruction, causing shortness of breath, wheezing, chest tightness, and difficulty exhaling air fully from the lungs. Importantly, in asthma, the symptoms often have a more abrupt onset compared to chronic conditions like COPD, and the patient is able to speak albeit with some difficulty, which aligns with the presentation of asthma rather than other conditions like pneumonia or COPD that typically produce additional signs such as fever, productive cough, or a longer history of symptoms. Pulmonary embolism is generally associated with acute onset, chest pain, and potentially lower oxygen saturations than those observed here.