47 y/o F with Fatigue, SOB, and Edema
G
General practitioner
5 yr of work experience
1/6/2025
47 y/o F w/ hx of HTN, presenting w/ persistent fatigue, mild SOB, and LE edema x3wks. BP 138/88, HR 92 reg, SpO2 96% RA. Labs: Hb 11.2, Cr 1.4 (baseline 0.9), eGFR 48, K 5.3, BNP mildly elevated, TSH normal. ECG shows nonspecific ST changes, no arrhythmias. CXR: borderline cardiomegaly, no pulm edema. Urinalysis: 1+ protein, no blood. Currently on amlodipine 10mg, no other meds. Unsure if early HF, CKD progression, or something systemic (amyloid, autoimmune?). Would you recommend further imaging (echo vs renal U/S), specific labs (ANA, SPEP, etc.), or straight to cardiology/nephro for eval?
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