Edema in the lower part of the body
Introduction
Introduction Low drooping edema is a typical sign of right heart failure. Occurred in the jugular vein filling and hepatic enlargement, most cases were isolated from right heart failure and isolated right heart failure subcutaneous edema. For the first sign of heart failure, before the peripheral edema is caused, a large amount of extracellular fluid must be accumulated. It is generally believed that the body weight has increased by about 10% before the onset of edema, that is, when the body fluid retention exceeds 5 kg, edema occurs. The water in the normal adult tissue gap is about 7kg, while in the heart failure, the water can be increased to 15-20kg. In heart failure, the water mainly stays in the extracellular space and the interstitial space, and the circulating blood volume and intracellular water only increase slightly. . Low drooping edema is also an early sign of cardiogenic edema.
Cause
Cause
Cardiac edema is caused by accumulation of excessive fluid in the interstitial space due to venous congestion of the systemic circulation caused by congestive heart failure.
Examine
an examination
Related inspection
M-mode echocardiography (ME) Doppler echocardiography two-dimensional echocardiography dynamic electrocardiogram (Holter monitoring)
The lower part of the body, the edema of the active person is most obvious in the back and the ankle; the supine in the supine is obvious.
The diagnosis of cardiogenic edema should have the following main features: 1 history of heart disease and symptoms: symptoms such as palpitations, difficulty breathing or shortness of breath, sitting breathing, coughing, and spitting white foamy sputum. 2 signs of heart disease: such as enlarged heart, organic murmur of the heart, jugular vein dilation, hepatic congestion and hematoma. Increased central venous pressure, prolonged blood circulation time, and wet sound of the lung base. 3 edema performance: for systemic depression edema, the two lower limbs are most obvious, related to body position. The degree of edema is closely related to the development and changes of cardiac function, and the improvement of heart failure and edema will be significantly reduced.
Diagnosis
Differential diagnosis
(1) Cardiac edema: rheumatism, hypertension, syphilis and other causes and valves; congestive heart failure caused by various diseases such as myocardium, constrictive pericarditis.
(2) Nephrogenic edema: acute glomerulonephritis, chronic glomerulonephritis, nephrotic syndrome, pyelonephritis, renal failure, renal arteriosclerosis, renal tubular disease, etc.
(3) Hepatogenic edema: liver cirrhosis, liver necrosis, liver cancer, acute hepatitis, etc.
(4) Malnutrition edema: 1 Insufficient intake of primary food, seen in war or other causes (such as severe famine); 2 secondary dystrophic edema is seen in a variety of pathological conditions, such as secondary Insufficient food intake (sexual anorexia, loss of appetite in severe illness, gastrointestinal disorders, pregnancy vomiting, neurological disorders, oral disorders, etc.) Digestive dysfunction (insufficient digestive juice, hyperactivity of intestinal tract, decreased absorption area, etc.) Excretion or loss Excessive (large area burns and exudation, acute or chronic blood loss, proteinuria, etc.) and impaired protein synthesis, severe diffuse liver disease.
(5) Edema caused by connective tissue disease: common in lupus erythematosus, scleroderma and dermatomyositis.
(6) allergic edema: such as serum disease.
(7) Endocrine edema: Syndrom of inappropriate secretion Of ADH SI-ADH, adrenal hyperfunction (Cushing's syndrome aldosterone secretion), hypothyroidism (hypophyseal anterior dysfunction) Symptoms, hypothalamic thyrotropin-releasing hormone secretion, and hyperthyroidism.
(8) idiopathic edema: this type of edema is a syndrome whose cause is unknown or whose cause has not been determined (may be more than one). More common in women, often associated with the periodicity of menstruation.
(9) Others: anemia edema, toxic edema in pregnancy.
