Clinical features of edema
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Clinical features of edema

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Clinical features of edema Presentation Transcript

  • 1. CLINICAL FEATURES OF EDEMA
  • 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. 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. • 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. 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. • Acute nephritic -mild -loose connective tissue-eyelids and face ,ankles,genitalia -moderate proteinuria• Both -more on waking up after sleep -generalised,pitting
  • 7. LIVER DISEASE• Liver Cirrhosis• Chronic liver disease -decreased protein synthesis -Ascites legs face
  • 8. NUTRITIONAL EDEMA• Protein losing enteropathy• Starvation• Dependent• Hypoproteinemia Albumin<2.5g/dL
  • 9. DRUG INDUCED EDEMA• Nifedipine-ankle edema• Corticosteroids• Estrogen• NSAIDs
  • 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. Pretibial myxodema
  • 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. 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. LOCALISED EDEMARedistribution of edema fluid, no accumulation• Cellulitis• DVT• Lymphedema• Angioneurotic• Trauma• Milroy’s edema• Nifedipine
  • 15. CELLULITIS,TRAUMA,COMPARTMENTSYNDROME,DVT • Localised • Sudden onset • Painful edema
  • 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. LYMPHADEMA• Surgery, radiation, chemotherapy• Filariasis• Nonpitting edema• localised
  • 18. MILROY’S EDEMA• Lymphedema at birth due to congenital absence of lymphatic tissue• Autosomal dominant inheritance• Unilateral limb edema progressive both legs
  • 19. REFEEDING EDEMA• Edema occurring following feeding after prolonged starvation• Increased salt intake• Insulin release sodium reabsorption
  • 20. THANK YOU