Differential Diagnosis for 36-year-old with Pitting Edema
- Single most likely diagnosis
- Heart failure: This is a common cause of pitting edema, especially in individuals with a history of hypertension, coronary artery disease, or cardiomyopathy. The edema is typically bilateral and affects the lower extremities.
- Other Likely diagnoses
- Nephrotic syndrome: Characterized by heavy proteinuria, hypoalbuminemia, and hyperlipidemia, leading to pitting edema due to decreased oncotic pressure.
- Liver cirrhosis: Causes pitting edema due to portal hypertension, hypoalbuminemia, and fluid retention.
- Deep vein thrombosis (DVT): Can cause unilateral pitting edema, especially if the thrombosis is extensive.
- Chronic venous insufficiency: Leads to pitting edema due to impaired venous return and increased venous pressure.
- Do Not Miss (ddxs that may not be likely, but would be deadly if missed.)
- Pulmonary embolism: Although less common, pulmonary embolism can cause pitting edema, especially if it leads to right heart strain or failure.
- Superior vena cava syndrome: Obstruction of the superior vena cava can cause pitting edema of the upper extremities and face.
- Constrictive pericarditis: A rare condition that can cause pitting edema due to impaired diastolic filling and increased venous pressure.
- Rare diagnoses
- Lymphedema: A chronic condition characterized by non-pitting edema, but can sometimes present with pitting edema in the early stages.
- Sarcoidosis: A systemic disease that can cause pitting edema due to lymphatic obstruction or cardiac involvement.
- Amyloidosis: A rare condition that can cause pitting edema due to cardiac or renal involvement.
- Hypothyroidism: Although rare, severe hypothyroidism can cause pitting edema due to decreased lymphatic drainage and increased capillary permeability.