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Edema
Last reviewed: 04.07.2025
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[ Causes of edema development
Edema of cardiac origin is characterized by symmetry and dependence on body position. In a vertical position, edema is observed mainly in the feet and shins. Leg edema increases in the evening, decreasing or disappearing in the morning after sleep. After pressing on the front surface of the shin, a noticeable dimple remains. With severe edema, there are always other signs of heart failure: an increase in the size of the heart, an enlarged liver and, most importantly, obvious signs of heart disease (usually, the diagnosis has already been established). Rapid edema may be observed in acute right ventricular failure.
In addition to heart failure, edema can be caused by diseases of the veins and lymphatic vessels of the legs (asymmetry of edema and its persistence in the lying position are typical), severe liver and kidney diseases, myxedema, obesity. The most common cause of edema is damage to the veins of the legs and obesity. Even healthy people may develop leg edema when standing for a long time, after a long walk in hot weather or when sitting for a long time, for example, during an airplane flight. Fluid retention and the appearance of edema are facilitated by increased salt and liquid intake, taking certain medications: corticosteroids and non-steroidal anti-inflammatory drugs.
Weakness and increased fatigue
Very subjective and non-specific symptoms. In most cases, the cause of the feeling of weakness and increased fatigue is detraining.
In patients with cardiovascular diseases, the cause may be heart failure (reduction of cardiac output and insufficient increase during physical exertion). But even in patients with heart failure, it is detraining that significantly increases the feeling of weakness and fatigue. And vice versa, as a result of physical training, it is possible to significantly increase physical performance even in severe heart diseases. The use of diuretics and hypotensive drugs can significantly increase the feeling of weakness.
Consider other medications and follow-up measures, especially in pulmonary edema:
1 line: |
Furosemide 0.5-1.0 mg/kg Morphine 1-3 mg Nitroglycerin under the tongue Oxygen inhalation (intubation) |
2 line: |
Nitroglycerin intravenously (if BP> 100) Nitroprusside IV (if blood pressure is very high) Dobutamine IV (if BP is normal) Dopamine IV (if BP < 100) |
3 line: |
Milrinone IV Aminophylline (if dry wheezing) Thrombolytics (for MI, if there is no shock) Digoxin (for atrial fibrillation) Intra-aortic balloon counterpulsation Coronary angioplasty, surgical treatment methods |
Symptoms of edema
The appearance of clinically expressed edema is usually preceded by an increase in body weight by several kilograms (which is especially important, for example, in chronic heart failure, when daily weighing of the patient is necessary to detect "hidden" edema). The skin with edema looks shiny, glossy, often, especially on the extremities, signs of peeling and cyanosis can be seen due to venous blood stagnation. In parallel with the increase in body weight, the patient notes a decrease in diuresis (oliguria).