85-year-old Mrs. Delaney has bilateral ankle and

85-year-old Mrs. Delaney has bilateral ankle and foot swelling for the past 3 weeks; she states her feet hurt and her shoes feel tight and describes this swelling as the first occurrence; she denies fever, erythema, warmth, or trauma. Past medical history: aortic valve replacement; hypertension; dyslipidemia; osteoporosis. Medications: amlodipine; benazepril; atorvastatin; alendronate sodium; aspirin. Physical examination: vital signs within normal limits; exam unremarkable except for grade 1 systolic ejection murmur at the left sternal border, second intercostal space with no radiation, and mild (< 1+) pitting edema bilateral ankles and feet. Note: Assume history and examination is within normal limits if not listed. Answer the following questions. Identify the probable diagnosis and what data support your decision. Describe the pathogenesis for the diagnosis. What data are inconsistent with your diagnosis? What diagnostic tests would you order, if any, and how would you treat this patient?

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