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Previous Volume 360:1016-1022 March 5, 2009 Number 10 Next

	Since this article has no abstract, we have provided an extract of the first 100 words of the full text and any section headings.

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In this Journal feature, information about a real patient is presented in stages (boldface type) to an expert clinician, who responds to the information, sharing his or her reasoning with the reader (regular type). The authors' commentary follows.

A 36-year-old man presented to the emergency department with a 2-week history of lower-extremity edema, progressive fatigue, and exertional dyspnea.

Edema reflects a disruption of interstitial-fluid homeostasis and typically indicates a cardiac, renal, hepatic, venous, or lymphatic pathology. Particularly important features on examination would include an estimation of central venous pressure, the presence or absence of pulmonary edema, the location of the . . . [Full Text of this Article]

Commentary

Source Information

From the Department of Medicine (N.R.D.) and the Divisions of Cardiovascular Medicine (S.C., A.N., R.P.G.) and Endocrinology (F.H.), Department of Medicine — all at Brigham and Women's Hospital, Boston.

Address reprint requests to Dr. Giugliano at the TIMI Study Group, Division of Cardiovascular Medicine, Brigham and Women's Hospital, 350 Longwood Ave., 1st Fl. Offices, Boston, MA 02115, or at rgiugliano@partners.org.

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