Clinical features of edema

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Clinical features of edema

  1. 1. CLINICAL FEATURES OF EDEMA
  2. 2. GENERALISED EDEMA-ANASARCA Fluid accumulation in tissues and body • Pericardial effusion fluids • Constrictive pericarditis• Cardiac failure • Myxedema• Renal disease • Idiopathic• Liver disease • Epidemic dropsy• Hypoproteinemia • Drugs
  3. 3. CARDIAC EDEMA• Right sided heart failure-systemic congestion and generalised edema• Left sided heart failure-initially pulmonary congestion and edema later generalised edema• Pitting• Dependent Ambulant-maximal over ankles & feet(pedal) -worse towards end of day -clears up with recumbence Bedridden-maximal over sacrum
  4. 4. • Legs face ascites• Early-nocturnal polyuria (clears up at night)• Later-established at all times• Clears with Diuretic therapy• Other signs of cardiac failure -exertional dysnea -engorged jugulars -tender hepatomegaly
  5. 5. RENAL EDEMA• Nephrotic ,Nephritic, Renal failure• Nephrotic -severe, generalised,dependent -loose connective tissue, subcutaneous tissue, visceral organs -face(periorbital) legs ascites (with scrotal swelling) Other features -massive proteinuria -hypoalbuminemia -hypercholesterolemia
  6. 6. • Acute nephritic -mild -loose connective tissue-eyelids and face ,ankles,genitalia -moderate proteinuria• Both -more on waking up after sleep -generalised,pitting
  7. 7. LIVER DISEASE• Liver Cirrhosis• Chronic liver disease -decreased protein synthesis -Ascites legs face
  8. 8. NUTRITIONAL EDEMA• Protein losing enteropathy• Starvation• Dependent• Hypoproteinemia Albumin<2.5g/dL
  9. 9. DRUG INDUCED EDEMA• Nifedipine-ankle edema• Corticosteroids• Estrogen• NSAIDs
  10. 10. ENDOCRINE• Myxodema- hypothyroidism, infiltrative edema due to deposition of mucinous material, nonpitting• Pretibial myxodema- Grave’s disease, swelling over shins, nonpitting• Cushing’s disease- hyperaldosteronism
  11. 11. Pretibial myxodema
  12. 12. EPIDEMIC DROPSY• Ingestion of edible oil contaminated with oil from seeds of argemone mexicana• Bilateral pitting edema of lower limbs generalised edema• Pigmentation of skin over edema• Fever,diarrhoea,abdominal pain,malaise
  13. 13. IDIOPATHIC EDEMA• Young menstruating women, not cyclical• Periodic episodes of edema with pain and discomfort• Sitting and standing-abdomen and legs• On lying down-face and eyelids• Diurnal weight changes• Has to be differentiated from cyclical edema
  14. 14. LOCALISED EDEMARedistribution of edema fluid, no accumulation• Cellulitis• DVT• Lymphedema• Angioneurotic• Trauma• Milroy’s edema• Nifedipine
  15. 15. CELLULITIS,TRAUMA,COMPARTMENTSYNDROME,DVT • Localised • Sudden onset • Painful edema
  16. 16. ANGIONEUROTIC EDEMA• Hypersensitivity• Solid edema-involves deeper layers of skin• Localised-Tongue,lips,face,eyelids• Develops rapidly,pale or faint pink, itching• Threatens life by suffocation• ACE inhibitor induced• Congenital-C1 esterase inhibitor deficiency
  17. 17. LYMPHADEMA• Surgery, radiation, chemotherapy• Filariasis• Nonpitting edema• localised
  18. 18. MILROY’S EDEMA• Lymphedema at birth due to congenital absence of lymphatic tissue• Autosomal dominant inheritance• Unilateral limb edema progressive both legs
  19. 19. REFEEDING EDEMA• Edema occurring following feeding after prolonged starvation• Increased salt intake• Insulin release sodium reabsorption
  20. 20. THANK YOU

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