A 45-year-old male, with a history of obesity and sedentary lifestyle, presents with increasing shortness of breath and ankle swelling. His blood pressure is 145/90 mmHg, and his BMI is 35. What are the potential causes, and what are the next steps?
The patient's symptoms could be related to obesity-related cardiomyopathy or heart failure, conditions more common in people with obesity. Other potential causes could be hypertension or chronic venous insufficiency. Next steps should include an ECG, chest X-ray, echocardiogram, and blood tests including BNP to assess for heart failure. Long-term management should focus on weight reduction, increased physical activity, and potentially medication.