EDEMA Dr Imrana Tanvir
Anatomy and pathophysilolgy <ul><li>1/3 of total body water is extracellular space, and 2/3 is intracellular space; </li><...
EDEMA <ul><li>Edema  is defined as a clinically apparent increase in the interstitial fluid volume  </li></ul><ul><li>Weig...
Pitting edema Non-pitting edema
Classification <ul><li>Pitting  </li></ul><ul><li>When pressure is applied to a small area, the indentation persists for s...
What causes edema? <ul><li>If the capillaries (tiny blood vessels) leak fluid into the surrounding tissue the area will st...
Symptoms <ul><li>Swelling or puffiness of the tissue directly under  skin. </li></ul><ul><li>Stretched or shiny skin. </li...
CME Cardio 2003 MCH Trivandrum
<ul><li>Five factors  contribute to the formation of edema : </li></ul><ul><ul><li>Increased  hydrostatic pressure . </li>...
Generalized Localized or Heart Liver    Kidney Nutritional Venous obstruction Lymphatic obstruction
Why does a patient with heart disease retain fluid? <ul><li>Heart failure is the result of poor cardiac function and is re...
<ul><li>Kidneys sense that there is a reduction of the blood volume in the body. To counter the seeming loss of fluid, the...
Why does edema occur in patients with kidney disease? <ul><li>Edema forms in patients with kidney disease for two reasons:...
<ul><li>Results in a decreased flow of blood to the kidneys.  </li></ul><ul><li>The kidneys sense that there is a reductio...
How does venous insufficiency cause edema? <ul><li>Veins of the legs have valves that prevent the backward flow of blood w...
What is idiopathic edema? <ul><li>Idiopathic edema is a pitting edema of unknown cause that occurs primarily in pre-menopa...
THANKS CME Cardio 2003 MCH Trivandrum
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Edema

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Edema

  1. 1. EDEMA Dr Imrana Tanvir
  2. 2. Anatomy and pathophysilolgy <ul><li>1/3 of total body water is extracellular space, and 2/3 is intracellular space; </li></ul><ul><li>Extracellular space is composed of the intravascular plasma volume (25%) and the extravascular interstitial spaces (75%); </li></ul>
  3. 3. EDEMA <ul><li>Edema is defined as a clinically apparent increase in the interstitial fluid volume </li></ul><ul><li>Weight gain precedes overt edema </li></ul><ul><li>Anasarca refers to gross, generalized edema. </li></ul><ul><li>Ascites and hydrothorax refer to accumulation of excess fluid in the peritoneal and pleural cavities, respectively, and are considered to be special forms of edema. </li></ul>
  4. 4. Pitting edema Non-pitting edema
  5. 5. Classification <ul><li>Pitting </li></ul><ul><li>When pressure is applied to a small area, the indentation persists for some time after the release of the pressure. Peripheral pitting edema, is the more common type, resulting from water retention. It can be caused by systemic diseases, pregnancy , as a result of heart failure, or local conditions such as varicose veins, thrombophlebitis, insect bites, and dermatitis. </li></ul><ul><li>Non-pitting edema </li></ul><ul><li>is observed when the indentation does not persist. It is associated with such conditions as lymphedema, lipoedema and myxedema. </li></ul><ul><li>Kwashiorkor </li></ul><ul><li>Edema caused by malnutrition defines . </li></ul>
  6. 6. What causes edema? <ul><li>If the capillaries (tiny blood vessels) leak fluid into the surrounding tissue the area will start to swell. This could be due to capillary damage or increased pressure. </li></ul>
  7. 7. Symptoms <ul><li>Swelling or puffiness of the tissue directly under skin. </li></ul><ul><li>Stretched or shiny skin. </li></ul><ul><li>Skin that retains a dimple after being pressed for several seconds. </li></ul><ul><li>Increased abdominal size. </li></ul>
  8. 8. CME Cardio 2003 MCH Trivandrum
  9. 9. <ul><li>Five factors contribute to the formation of edema : </li></ul><ul><ul><li>Increased hydrostatic pressure . </li></ul></ul><ul><ul><li>R educed oncotic pressure within blood vessels . </li></ul></ul><ul><ul><li>Increased blood vessel wall permeability as in inflammation . </li></ul></ul><ul><ul><li>O bstruction of fluid clearance via the lymphatic system. </li></ul></ul><ul><ul><li>Changes in the water retaining properties of the tissues. </li></ul></ul>
  10. 10. Generalized Localized or Heart Liver Kidney Nutritional Venous obstruction Lymphatic obstruction
  11. 11. Why does a patient with heart disease retain fluid? <ul><li>Heart failure is the result of poor cardiac function and is reflected by a decreased volume of blood pumped out by the heart. </li></ul><ul><li>Heart failure can be caused by weakness of the heart muscle, which pumps blood out through the arteries to the entire body, or by dysfunction of the heart valves. </li></ul><ul><li>Decreased cardiac output is responsible for a decreased flow of blood to the kidneys. </li></ul>CME Cardio 2003 MCH Trivandrum
  12. 12. <ul><li>Kidneys sense that there is a reduction of the blood volume in the body. To counter the seeming loss of fluid, the kidneys retain salt and water. </li></ul><ul><li>This fluid increase ultimately results in the buildup of fluid within the lungs, which causes shortness of breath (pulmonary edema). </li></ul>CME Cardio 2003 MCH Trivandrum
  13. 13. Why does edema occur in patients with kidney disease? <ul><li>Edema forms in patients with kidney disease for two reasons: </li></ul><ul><li>Heavy loss of protein in the urine. </li></ul><ul><li>Impaired kidney (renal) function. </li></ul>CME Cardio 2003 MCH Trivandrum
  14. 14. <ul><li>Results in a decreased flow of blood to the kidneys. </li></ul><ul><li>The kidneys sense that there is a reduction of the blood volume in the body. </li></ul><ul><li>To counter the seeming loss of fluid, the kidneys retain salt and water. </li></ul>CME Cardio 2003 MCH Trivandrum
  15. 15. How does venous insufficiency cause edema? <ul><li>Veins of the legs have valves that prevent the backward flow of blood within them. </li></ul><ul><li>Venous insufficiency is incompetence of the veins that occurs because of dilation, or enlargement, of the veins and dysfunction of their valves. This happens, for example, in patients with varicose veins. </li></ul><ul><li>Venous insufficiency leads to a backup of blood and increased pressure in the veins, thereby resulting in edema of the legs and feet </li></ul>CME Cardio 2003 MCH Trivandrum
  16. 16. What is idiopathic edema? <ul><li>Idiopathic edema is a pitting edema of unknown cause that occurs primarily in pre-menopausal women who do not have evidence of heart, liver, or kidney disease. </li></ul>CME Cardio 2003 MCH Trivandrum
  17. 17. THANKS CME Cardio 2003 MCH Trivandrum

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