What are your top 3 differential diagnoses?

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A 55 year-old male patient presents to your clinic for his initial visit requesting refills of his blood pressure and blood sugar medication. He states he has been out of his medications for about 3 months and can’t remember the name of either of them. He is also complaining of shortness of breath and chest discomfort over the past week that is gradually worsening. He mentions that he thinks the scale in the clinic may be wrong because he when he weighed himself last week he was 10 pounds lighter than he is today. VS: Temp- 98.6, HR – 112, Resp – 26, BP- 176/100, pulse ox 94%, ℅ 4/10 chest pain. What other questions would you ask this patient? What are your top 3 differential diagnoses? What is your plan for this patient?

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