Triage Note: Headache and shortness of breath since yesterday. Also, noticed her heart rate has consistently been over 100 on her watch.
History of Present Illness: A female in her late 30’s comes in with 2 days of shortness of breath, mild gradual onset generalized headache and noticing an increased heart rate on her Apple watch. No fever, chills, cough, runny nose, vomiting, focal weakness, sudden onset or other complaints. Headache is currently gone but heart rate is still elevated and she still feels out of breath. No chest pain. No other complaints. She recently started phentiramine
Vital Signs: T: 37.1 °C HR: 85 RR: 17 BP: 128/81 SpO2: 100%
Physical Exam: Essentially normal except for tachycardia
Diagnostic Testing: CBC and metabolic panel and viral panel all essentially normal. Chest x-ray shows no acute disease. Patient remained tachycardic after oral fluids so IV established and D-dimer ordered which was positive. CT negative for pulmonary embolism but did show incidental findings including hepatic steatosis and a 1.1 cm calcified left thyroid nodule.
What is the most likely diagnosis?
- A) Thyrotoxicosis
- B) Drug toxicity
- C) Anxiety
- D) None of the above
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What is the most likely diagnosis?
CASE CONCLUSION: TSH 0.03 (normal 0.45-5.33)
