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).

Initial swelling of the legs and lower back can be easily detected by palpation: two or three fingers press on the soft tissues in the area of the inner surface of the tibia (where the bone "pad" is located under the skin), and if swelling is present, the resulting pit disappears in 2-3 minutes. Similar pits on the shin are formed by pressing if body weight has increased by at least 10-15%.

• A mild degree of swelling is called "pastosity". It is characterized by barely noticeable swelling of the lower extremities, which practically does not leave a pit when pressed.
• The extreme expression of generalized edema of subcutaneous fat is anasarca. In this case, edema is detected on any part of the body, even on the anterior chest wall, which can be detected by pressing with a stethoscope during auscultation.
• Fluid accumulation in the abdominal cavity is called ascites, in the thoracic cavity - hydrothorax, in the pericardial cavity - hydropericardium. Fluid accumulation in serous cavities may accompany anasarca.

Hydrostatic and hydrodynamic factors explain the primary appearance of edema in low-lying areas of the body (lower limbs).

• In heart diseases accompanied by heart failure, edemas appear more often towards the end of the day, especially if the patient is in a vertical position for a long time. In addition to changes in the appearance of the limbs, the patient may also notice difficulties when putting on shoes, especially in the evening, or putting a ring on a finger.
• In kidney diseases, small swellings often appear first on the face (in the eyelid area) and usually in the morning. The patient's relatives may be the first to notice the appearance of such swelling.
• In rare cases, edema may appear in elderly people after prolonged periods of standing in an upright position, which is not of great clinical significance (like edema in women during the hot season).

It is also important to assess the prevalence of edema. In diseases of the heart, kidneys, liver, intestines, endocrine glands, edema can be widespread. In case of venous and lymphatic outflow disorders, allergic reactions, edema is more localized and often asymmetrical.

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