Today, I want to talk about the differential diagnosis of lower extremity edema.
I recently had a patient come in to the emergency department with this very chief complaint. When I went to talk to her, she also complained of fatigue and shortness of breath on exertion.
She had a history of chronic atrial fibrillation, so naturally I’m fixated on this case being a new diagnosis of CHF. I also came to realize she had CKD stage 4, a fistula placed, but wasn't on dialysis.
I ordered troponin, EKG, CXR, BNP, CBC, CMP, TSH, and urine analysis. But, turns out she didn't have congestive heart failure.
Her hgb was 5.1 and her creatine jumped as well. With this, I was sure this patient had worsening chronic kidney disease. Because of this I want to focus on the differential for bilateral lower extremity edema.
Points I will discuss:
- The CXR findings of CHF
- Medication causes of lower extremity edema
- Other than heart failure, what other organ failure causes LE edema?
- Acute versus chronic differential diagnosis of LE edema
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This video should not be used in any legal capacity whatsoever, including but not limited to establishing standard of care in a legal sense or as a basis for expert witness testimony. No guarantee is given regarding the accuracy of any statements or opinions made on the podcast, video, or blog.
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