Case Scenario

  • A 50-year-old woman presents to your clinic for routine follow-up. She has a history of hypertension for ~ 15 years. She mentioned that she has noted fatigue and increased swelling in her lower extremities during the past several weeks.
    Medications: Amlodipine (CCB) 10 mg OD.

On Physical Examination

  • She appears to be in no apparent distress.
  • Height: 153 cm
  • Weight: 100 kg
  • Blood pressure: 165/98 mmHg
  • Pulse: 85/minute
  • RR: 20/minute
  • Cardiac exam was remarkable for an S1, S2, and S4.
  • Lungs were clear to auscultation and percussion.
  • Abdomen: obese, non-tender and without masses or bruits.
  • Lower extremities had good pulses with pitting edema.
  • Other systemic examination was normal.

Differential Diagnosis of Lower Limb Edema

  • Venous Insufficiency
  • Heart Failure
  • Pulmonary Hypertension
  • Drugs (e.g., CCB & NSAIDs)
  • Idiopathic Edema
  • Lymphedema
  • Deep Vein Thrombosis
  • Obesity