70-Year-Old Man With Fatigue, Shortness of Breath, and Bilateral Lower Extremity Edema

A 70-year-old man presented for evaluation of 5 months of fatigue, shortness of breath, and bilateral lower extremity edema. His medical history was notable for coronary artery disease with coronary artery bypass grafting 2 years previously, nicotine dependence (>30 pack-years), type 2 diabetes mellitus, hypothyroidism, and obesity (body mass index, 30 kg/m2). Medications included furosemide, spironolactone, aspirin, atorvastatin, and levothyroxine. Review of systems revealed dyspnea with exertion (New York Heart Association, class III-IV; Eastern Cooperative Oncology Group score, 4), orthostatic hypotension, bloating, early satiety with a 9-kg unintentional weight loss over 4 months, lower extremity edema, and discoloration around the left eye.
Source: Mayo Clinic Proceedings - Category: Internal Medicine Authors: Tags: Residents' Clinic Source Type: research