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Emergency Medical Minute


May 29, 2019

Author: Peter Bakes, MD

Educational Pearls:

  • The differential diagnosis for pedal edema includes issues in the heart, kidney, and liver
  • Obesity hypoventilation syndrome (OHS) is an important and common cause of right heart failure. Nighttime hypoventilation leads to pulmonary hypertension, causing right heart strain followed by right heart failure
  • OHS criteria includes obesity, sleep disordered breathing, and alveolar hypoventilation (PaCO2 > 45 mmHg)
  • The causes of OHS are multifactorial, and include mechanical problems with breathing and hormonal changes


Balachandran JS, Masa JF, Mokhlesi B. Obesity Hypoventilation Syndrome Epidemiology and Diagnosis. Sleep Med Clin. 2014;9(3):341–347. doi:10.1016/j.jsmc.2014.05.007

Summarized by Will Dewispelaere, MS3 | Edited by Erik Verzemnieks, MD