Question on edema and symptoms

[ajbidi]

Hello, This is not necessarily a prevention question but I was hoping you'd be able to help.  I'm a 30 yr old man with about a 6-10 month history of shortness of breath with exertion and at rest, and awakening from my sleep with it.   Also,  I have been unusually fatigued with episodes from day to day of weakness, nausea, near syncope or lightheadedness.     Also I have frequent headaches, almost daily.

Very recently, about 3 weeks ago I developed bilateral (about +1) periphreal edema in my lower legs, ankles, and mostly upper feet.   I have never, ever had edema before.  I returned to my doctor when I noticed this and he checked my CBC, Metablolic panel,   and the usual basic labs  with normal results  (sodium normal).

I am very concerned about the new onset of edema in combonation with my symptoms, especially since I'm only 30 and have never had edema.    I have had an intensive cardiac evaluation already -  Thallium stress,  resting echo, Cardiac CTA,  Chest xray,  BNP blood test.     Bilirubin/Liver panel.....Everything is basically normal.  

I also have had a Brain MRI and abdomen/pelivc CT  a year ago for unrelated reasons (it turned out to be gastritis causing my abdominal pain),
and in my liver there was some vague mention of "tiny hypodensities most likely representing liver cysts",  however the CT was reported as normal.

I gather that Kidneys, Liver and Heart are the main serious causes of edema?    With a normal cardiac workup, normal ejection fraction, normal BNP....Normal Liver Panel,  normal Metabolic panel....  Is there anything at all left to look for in new onset of periphreal edema with these symptoms?

Thank you.

[Lee Kirksey, MD]

I would be interested in knowing if your vasculature is uninterrupted ie ultrasound shows no deep venous thrombosis or evidence of vena caval compromise by CT or MRV. that sounds like it would complete your workup. thanks