Differential Diagnosis for Pitting Oedema in Both Lower Limbs but Only Left Upper Limb in Congestive Cardiac Failure (CCF)
- Single Most Likely Diagnosis:
- Congestive cardiac failure with left-sided subclavian vein thrombosis or obstruction: This is likely because CCF typically causes bilateral lower limb edema due to fluid overload, and the isolated left upper limb edema could be due to a localized obstruction or thrombosis in the left subclavian vein, which is a known complication in patients with central venous catheters or other conditions affecting the subclavian vein.
- Other Likely Diagnoses:
- Congestive cardiac failure with left-sided lymphedema: This could be due to various causes such as surgery, radiation, or infection affecting the lymphatic drainage of the left upper limb.
- Superior vena cava syndrome with left-sided subclavian vein obstruction: Although less common, this could cause edema in the left upper limb if the obstruction is localized to the left subclavian vein.
- Do Not Miss Diagnoses:
- Pulmonary embolism with associated left upper limb deep vein thrombosis: Although less likely, it is crucial to consider this diagnosis due to its high mortality rate if missed.
- Aortic dissection with left subclavian artery involvement: This is a life-threatening condition that could cause differential blood pressure readings between the two arms and should not be missed.
- Rare Diagnoses:
- Thoracic outlet syndrome with left subclavian vein compression: This is a rare condition that could cause edema in the left upper limb due to compression of the subclavian vein.
- Left-sided upper limb heart failure due to a cardiac anomaly: Certain cardiac anomalies, such as a left-sided superior vena cava, could cause isolated left upper limb edema due to heart failure.