Douglas S. Paauw, MD


April 16, 2015

A 78-year-old man presents to his physician for evaluation of edema. He reports a 3-month history of bilateral peripheral edema. He has had no pain or shortness of breath. His medical history is notable for hypertension, Parkinson disease, depression, and type 2 diabetes. His current medications include:

  • Lisinopril;

  • Diltiazem;

  • Atorvastatin;

  • Pramipexole;

  • Escitalopram; and

  • Metformin.

In the office today his blood pressure is 110/70 mm Hg with a heart rate of 70 beats/min. On exam, you note no increased jugular venous pressure. His chest is clear to auscultation, and his lower extremities have 2+ edema bilaterally.


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