Edema

EDEMAEDEMA

Dr Imrana Tanvir

Anatomy and pathophysilolgy

1/3 of total body water is extracellular space, and 2/3 is intracellular space;

Extracellular space is composed of the intravascular plasma volume (25%) and the extravascular interstitial spaces (75%);

EDEMA

Edema is defined as a clinically apparent increase in the interstitial fluid volume

Weight gain precedes overt edema Anasarca , refers to gross generalized

. edema 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

Pitting edema Non-pitting edema

Classification

Pitting 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.

Non-pitting edema is observed when the indentation does not persist. It is

associated with such conditions as lymphedema, lipoedema and myxedema.

Kwashiorkor Edema caused by malnutrition defines.

What causes edema?

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.

Symptoms

Swelling or puffiness of the tissue directly under skin.

Stretched or shiny skin. Skin that retains a dimple after being

pressed for several seconds. Increased abdominal size.

Five factors contribute to the formation of edema: Increased hydrostatic pressure. R educed oncotic pressure within blood

vessels. Increased blood vessel wall

permeability as in inflammation. O bstruction of fluid clearance via the

lymphatic system. Changes in the water retaining

properties of the tissues.

Generalized

Localized

or

HeartLiver

Kidney Nutritional

Venous obstruction

Lymphatic obstruction

Why does a patient with heart disease retain fluid? Heart failure is the result of poor cardiac

function and is reflected by a decreased volume of blood pumped out by the heart.

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.

Decreased cardiac output is responsible for a decreased flow of blood to the kidneys.

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.

This fluid increase ultimately results in the buildup of fluid within the lungs, which causes shortness of breath (pulmonary edema).

Why does edema occur in patients with kidney disease?Edema forms in patients with kidney

disease for two reasons: Heavy loss of protein in the urine.

Impaired kidney (renal) function.

Results in a decreased flow of blood to the kidneys.

The 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.

How does venous insufficiency cause edema? Veins of the legs have valves that prevent

the backward flow of blood within them. 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.

Venous insufficiency leads to a backup of blood and increased pressure in the veins, thereby resulting in edema of the legs and feet

What is idiopathic edema? 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.

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