Primary and differential diagnoses
The patient states that she typically only feels the stated symptoms after working out, but lately she has consistently felt that way. She denies symptoms related to upper respiratory system, gastrointestinal, or urinary. The objective findings reveal vital signs that are within normal limits and the patient is in no signs of respiratory distress. Assessment of head, eyes, ears, nose, and throat are not impressive, and the inspection of the anterior and posterior chest show no abnormalities. While auscultating the patient’s chest, decreased air movement and high-pitched whistling on expiration was observed. The lungs were also noted to be resonant upon percussion.
The primary diagnosis for this patient is severe persistent asthma. Asthma is defined as complex and it typically involves airway inflammation, intermittent airflow obstruction, as well as bronchial hyperresponsiveness. Symptoms usually involve wheezing, coughing, shortness of breath, as well as chest tightness and pain (Morris, 2022). The patient is feeling these same symptoms daily, multiple times a day, and throughout the night, with a nocturnal nonproductive cough, therefore this is the final diagnosis for this patient.
Primary and differential diagnoses
The first differential diagnosis is viral bronchiolitis, which is defined as “an acute inflammatory injury of the bronchioles that is usually caused by a viral infection” (Maraqa, 2021). Congestive heart failure is another differential diagnosis as well as chronic sinusitis. Congestive heart failure is a condition that causes pulmonary vessels and interstitial pulmonary edema, reducing the compliance of the lungs, therefore leading to a feeling of dyspnea and wheezing (Morris, 2022). Acute sinusitis is an “inflammatory process involving the paranasal sinus” (Brook, 2022), and it may be associated with allergies. It can lead to unproductive cough as well as exacerbation of asthma.