Edema
Basics
Description
Description
- Clinically apparent accumulation of extravascular fluid due to a derangement in the balance of oncotic and hydrostatic forces:
- Increase in venous/capillary hydrostatic pressure
- Decrease in plasma oncotic pressure
- Increase in interstitial oncotic pressure
- Increase in capillary permeability
- Increase in lymphatic pressure due to obstruction
- Combination of these factors
- Generalized, as with CHF or nephrotic syndrome
- Localized, as with deep vein thrombosis
- Increased venous hydrostatic pressure or decreased oncotic pressure results in pitting edema
- Protein-rich extravasated fluid results in nonpitting edema
- In certain disorders, there is no clear relation to Starling forces:
- Idiopathic (cyclic) edema:
- Worsened with heat
- More common in women
- Not necessarily related to menses
- Idiopathic (cyclic) edema:
Etiology
Etiology
- Generalized:
- Heart failure
- Cor pulmonale
- Cardiomyopathies
- Constrictive pericarditis
- Pulmonary HTN:
- Sleep apnea
- COPD
- Acute glomerulonephritis
- Renal failure
- Medication related (often secondary to salt retention):
- Steroids/estrogens/progestins
- NSAIDs
- Antihypertensives (especially vasodilators)
- Minoxidil
- Sympathetic blockers (clonidine, guanethidine, methyldopa)
- Lithium
- Insulin
- Thiazolidinediones (glitazones)
- Growth hormone
- Interleukin-2
- MAOIs
- Pramipexole
- Docetaxel
- Cyclosporine
- OKT3 monoclonal antibody
- Acute withdrawal of diuretics
- Idiopathic (cyclic) edema
- Myxedema
- Cirrhosis
- Nephrotic syndrome
- Protein-losing enteropathy/malabsorption
- Starvation
- Pregnancy
- Localized:
- Deep vein thrombosis
- Venous insufficiency
- Thrombophlebitis
- Chronic lymphangitis
- Cellulitis
- Baker cyst
- Vasculitis
- Angioedema:
- Allergic
- Acquired
- Hypothyroidism (myxedema)
- Mechanical trauma
- Thermal injuries
- Radiation injuries
- Chemical burns
- Hemiplegia
- Reflex sympathetic dystrophy
- Compressive or invasive tumor
- Postsurgical resection of lymphatics
- Post irradiation
- Filariasis
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Citation
Schaider, Jeffrey J., et al., editors. "Edema." 5-Minute Emergency Consult, 6th ed., Lippincott Williams & Wilkins, 2020. Emergency Central, emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307198/3.0/Edema.
Edema. In: Schaider JJJ, Barkin RMR, Hayden SRS, et al, eds. 5-Minute Emergency Consult. Lippincott Williams & Wilkins; 2020. https://emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307198/3.0/Edema. Accessed December 3, 2024.
Edema. (2020). In Schaider, J. J., Barkin, R. M., Hayden, S. R., Wolfe, R. E., Barkin, A. Z., Shayne, P., & Rosen, P. (Eds.), 5-Minute Emergency Consult (6th ed.). Lippincott Williams & Wilkins. https://emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307198/3.0/Edema
Edema [Internet]. In: Schaider JJJ, Barkin RMR, Hayden SRS, Wolfe RER, Barkin AZA, Shayne PP, Rosen PP, editors. 5-Minute Emergency Consult. Lippincott Williams & Wilkins; 2020. [cited 2024 December 03]. Available from: https://emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307198/3.0/Edema.
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BT - 5-Minute Emergency Consult
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