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Edema
Last reviewed: 23.04.2024
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[Causes of edema development
For edema of cardiac origin, symmetry and dependence on the position of the body are characteristic. In the vertical position, edema is noted mainly in the area of the feet and legs. Swelling of the legs accrue towards evening, diminishing or disappearing in the morning after sleep. After pressing on the anterior surface of the tibia, a prominent fossa remains. With severe swelling there are always other signs of heart failure: an increase in heart size, an increase in the liver and, most importantly, obvious signs of heart disease (as a rule, the diagnosis is already established). Rapid build-up of edema can occur with acute right ventricular failure.
In addition to heart failure, the cause of edema can be diseases of the veins and lymphatic vessels of the legs (asymmetry of the edema and their preservation in the prone position are characteristic), severe liver and kidney disease, myxedema, obesity. The most common cause of edema is leg vein injury and obesity. Even in healthy people, swelling of the legs may occur with prolonged standing in the vertical position, after a long walk in hot weather or with prolonged sitting, for example, during flight in an airplane. The delay of fluid and the appearance of edema is promoted by an increase in the intake of salt and liquid, the intake of certain medications: corticosteroids and non-steroidal anti-inflammatory drugs.
Weakness and fatigue
Very subjective and nonspecific symptoms. In most cases, the cause of a feeling of weakness and increased fatigue is detune.
In patients with cardiovascular diseases, the cause may be heart failure (a decrease in cardiac output and an insufficient increase in cardiac output). But even in patients with heart failure, it is the detenity that significantly increases the feeling of weakness and fatigue. Conversely, as a result of physical training, it is possible to significantly improve physical performance even in severe heart conditions. The use of diuretics and hypotensive drugs can significantly increase the feeling of weakness.
Consider the advisability of introducing other drugs and further activities, especially with pulmonary edema:
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1 line: |
Furosemide 0.5-1.0 mg / kg Morphine 1-3 mg Nitroglycerin under the tongue Inhalation of oxygen (intubation) |
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2 line: |
Nitroglycerin IV (if ADC> 100) Nitroprusside IV (if very high blood pressure) Dobutamine IV (if blood pressure is normal) Dopamine IV (if ADC <100) |
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3 line: |
Milrinone IV Aminophylline (if dry wheezes) Thrombolytics (with MI, if there is no shock) Digoxin (with atrial fibrillation) Intra-aortic balloon counterpulsation Coronaroangioplasty, surgical methods of treatment |
Symptoms of edema
The appearance of clinically pronounced edema is usually preceded by a weight gain of several kilograms (which is particularly important, for example, in chronic heart failure, when daily weighing of the patient is necessary to detect "hidden" edema). Skin with swelling looks shiny, shiny, often, especially on the limbs, you can see signs of ecdysis and cyanosis due to stagnation of venous blood. Parallel to the increase in body weight, the patient notes a decrease in diuresis (oliguria).