What is the cause of an 82-year-old female with Diastolic (heart failure with preserved ejection fraction) heart failure presenting with erythema and swelling of the fingers and toes?

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Differential Diagnosis for 82 year old female with Diastolic heart failure and red swollen finger and toe

  • Single most likely diagnosis
    • Chilblains: This condition is characterized by inflammation of small blood vessels in response to cold temperatures, leading to red, swollen, and painful fingers and toes. It is more common in older adults and those with poor circulation, which may be exacerbated by diastolic heart failure.
  • Other Likely diagnoses
    • Cellulitis: A bacterial skin infection that can cause redness, swelling, and warmth of the affected area. It is a common condition in older adults, especially those with compromised circulation.
    • Gout: A form of arthritis that can cause sudden, severe attacks of pain, swelling, and redness in the joints, often affecting the toes.
    • Peripheral artery disease (PAD): A condition where narrowed arteries reduce blood flow to the limbs, leading to pain, swelling, and discoloration.
  • Do Not Miss (ddxs that may not be likely, but would be deadly if missed.)
    • Sepsis: A life-threatening condition that occurs when the body's response to an infection becomes uncontrolled and causes widespread inflammation. It can present with non-specific symptoms, including redness and swelling of the extremities.
    • Deep vein thrombosis (DVT): A blood clot that forms in the deep veins of the body, which can cause swelling, redness, and warmth of the affected area. It is a medical emergency that requires prompt treatment.
    • Gangrene: A condition where tissue dies due to lack of blood supply, which can be caused by various factors, including infection, trauma, or poor circulation.
  • Rare diagnoses
    • Erythromelalgia: A rare disorder that causes burning pain, heat, and redness in the hands and feet, often accompanied by swelling.
    • Raynaud's phenomenon: A condition that affects blood flow to the fingers and toes, causing them to turn white or blue in response to cold temperatures or stress.
    • Complex regional pain syndrome (CRPS): A chronic pain condition that can cause swelling, redness, and warmth of the affected area, often accompanied by intense burning pain.

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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