A 50-year-old man with a history of alcohol abuse presents with progressive shortness of breath and lower extremity edema. On examination, there are signs of fluid overload including elevated jugular venous pressure and a positive hepatojugular reflux. What could be the potential causes and the next steps?
Given his history of alcohol abuse, this patient's presentation is suggestive of alcoholic cardiomyopathy, a dilated cardiomyopathy leading to heart failure. The next steps would include an echocardiogram to evaluate the heart's structure and function, along with a BNP test. Treatment would include diuretics to relieve fluid overload, lifestyle modifications including abstinence from alcohol, and possibly medications like ACE inhibitors or beta-blockers.