Monday, October 19, 2009

Is Pitting Edema a sign of any type of a Cardiac Problem?? -

43yo, non smoking WF, no family hx except hypertension. I do not have high B/P. I have fibromyalgia, asthma, Osteoarthritis, chondromalacia patellae of both knees,gastric bypass. I have edema in my legs from knees down. This keeps happening off and on. Right now it is really bad, the pitting is 1+/2+ and my R is esp bad, even my foot is swollen and you can t see my ankle! I wonder if that chondro would cause this? I ask about Cardio because ppl will see me like this and say quot;Has your Dr had your heart checked out?quot; Once a Dr did a few blood studies but they were normal and I dont know what it was. I havent injured myself, I am on several meds but I have been on these same ones for a while now. My PCP has tx d this with Lasix in the past. I can go to the ER but dont know if they ll do anything since I dont have ins. . Please give me some answers and not just see your DR. I am an RN and I know this. I just dont want to go and it be normal with my knees.. etc.. It is really uncomfortable.

Pitting edema can be demonstrated by applying pressure to, for example, the skin of a swollen leg, by depressing the skin with a finger. If the pressing causes an indentation in the skin that persists for some time after the release of the pressure, the edema is referred to as pitting edema. Actually, any form of pressure, such as from the elastic part of socks, can induce the pitting of this edema. In non-pitting edema, which usually affects the legs or arms, pressure that is applied to the skin does not result in a persistent indentation. Non-pitting edema can occur in certain disorders of the lymphatic system such as lymphedema, which is a disturbance of the lymphatic circulation that may occur after a radical mastectomy, or congenital lymphedema. Another cause of non-pitting edema of the legs is called pretibial myxedema, which is a swelling over the shins that occurs in some patients with hyperthyroidism. Non-pitting edema of the legs is difficult to treat. Diuretic medications are generally not effective, although elevation of the legs periodically during the day and compressive devices may reduce the swelling. The focus of the rest of this article is on pitting edema. What causes pitting edema? Edema is caused by either systemic diseases, that is, diseases that affect the various organ systems of the body, or by local conditions involving just the affected extremities. The most common systemic diseases that are associated with edema involve the heart, liver, and kidneys. In these diseases, edema occurs primarily because of the body s retention of too much salt (which is the chemical compound sodium chloride). The excess salt holds excess water in the interstitial tissue spaces, where the retained surplus of fluid is recognized as edema. Idiopathic (of unknown cause) edema, also sometimes called cyclical edema, occurs most often in women and just prior to each menstrual period. The most common local conditions that cause edema are varicose veins and thrombophlebitis (a blood clot with inflammation of the veins) of the deep veins of the legs. These conditions can cause inadequate pumping of the blood by the veins (venous insufficiency). The resulting increased back-pressure in the veins forces fluid to leak into the interstitial tissue spaces, where the retained excess fluid is recognized as edema.

Any chronic lung disease will result pitting edema as well, heavy smoker with obstructed lung may develop edema too...Sitting wrong position will result it too...etc. There is really many causes, CHF is just one of it but it is potentially more dangerous and common find than other causes. Report Abuse

First, being an RN, you should demonstrate greater knowledge than you do. At any rate, you really do need to see a doctor because the conditions that cause pitting edema are vary serious-four that come to mind, allergies, cardiac(heart) problems(you identified), hepatic(liver) damage, and respiratory(lung) problems. Have your heart and liver enzymes, and blood gases tested. These tests may run you around $200.00-less if have connections and get them at cost.

It s hard for me a CHF patient to give advice to an RN. Edema can have many causes- Heart, kidneys... all of which warrant investigation. CHF, Congestive Heart Failure is definitely a cause of edema. If I called my cardiologist and told him I was swollen like you, I would be told to take a lasix, put on compression stockings and lay down with my legs elevated. Minimal fluids ( 4 cups per day) and NO sodium. It works like a charm, particularly if you get to it early. Good luck.

well...some edema maybe caused by cardiac problems such as Congestive Heart Failure (CHF). Right side heart failure may cause edema of the legs, liver and etc. and Left side heart failure usually strikes the pulmonary system and may cause pulmonary edema. Consult your M.D. Regards Member: http://PhilippineNursing.blogspot.com

GREETINGS, first off did you always have the edema or is that new since the gastric surgery? You said blood studies were normal but what about tests for vein problems? veinogram? It s amazing all the replies you got here and the RN s did not once mention lymphedema and the person who did, didn t have the right info. Pitting edema is from lymphedema, non-pitting edema is when the area hardens with fibrosis and is harder than a rock which occurs a long time after having untreated lymphedema. You could have lymphedema and in that case lasik is not recommended because it pushes the water part of lymph out and leaves behind the debris to become fibrotic. You do need a veinogram regardless of insurance or not, it s well worth paying for yourself so you are sure there are no blood clots or vein problems left over from the surgery. With your problems with the fibro, the muscles probably spasm alot, then you have the osteoarthritis, and the surgery for the gastric bypass, they cut into your abdomen I m assuming that s alot of areas affected that can block or impede the lymph from flowing, plus being obese before that put a strain on your system. You also have the autoimmune problems that come with lymphedema, but you do need to rule out veins first. You can be treated with complete/complex decongestive therapy which is a form of medical lymphatic massage therapy, then fitted with compression hose after the treatment is done. If your doctor does diagnose you with lymphedema, contact me and I ll help you find a therapist.

Edema is a general term for swelling in the body due to the buildup of excess fluid in the tissues. It generally occurs when the pressure on oxygen-poor blood in the veins increases, and the fluid portion of the blood is forced out of the veins and into the surrounding soft tissues. This expands or swells the tissues. Edema is not a condition itself, but is the symptom of an underlying condition. Edema may occur in different parts of the body due to a variety of underlying causes, only some of which may be serious. For example, edema in the legs and ankles may be related to heart failure. The most serious form of edema is pulmonary edema, a buildup of fluid in the lungs. Pulmonary edema is usually a sign of heart failure, in which the heart is not pumping well enough to meet the body’s demand for oxygen. Patients with pulmonary edema usually complain of shortness of breath. Edema can also be caused by factors such as medication use, burns, and conditions such as venous insufficiency. Venous insufficiency occurs when the veins of the leg no longer allow normal blood flow, usually because the valves in these veins stop functioning properly. Under normal circumstances, blood in the veins is only allowed to flow in one direction, back toward the heart. If, however, the valves are compromised for some reason, blood is allowed to flow backward, away from the heart. This raises blood pressure in the veins of the legs, which may lead to a variety of health problems, including edema, pain, discoloration or ulcers that do not heal. People who have a more serious form of edema (e.g., pulmonary edema) may also experience the following: Rapid and labored breathing Shortness of breath (dyspnea) Coughing, sometimes with frothy blood Bluish tint to the skin, lips, fingernails and other areas of the body (cyanosis) Cold extremities (e.g., cold feet) Sense of feeling suffocated

Hi, I am an RN too. I suppose it depends on a few things. Generally if you have some type of cardiac failure it can cause oedema in your lower legs as an intial symptom but go on to result in pulmonary oedema so you need to watch out for those signs. When I see patients with this they typically can some bloods done and have an increase in diuretics to see if it helps as a first line. You are quite young to have heart failure although by having a gastric bypass I imagine you may have been mordibly obese at one time which may have caused alot of pressure on your heart. The other thing I would be wary of would be your nutritional status. If you are low in protein it can result in a low albumin level resulting in loss of fluid from the blood into the interstital cells resulting in oedema. Gastric Bypass is well known to cause malnutrition so ask for this to be checked into. The other thing is that due to be being morbidly overweight for a long time you most like have caused damage to your venous return (valves in your veins are shot) due to the high pressure sustained over years in your lower limbs. Even if you dont have varicose veins this can still occur due to problems in your deeper veins. This can result in oedema in your lower legs. However, if it has been a sudden onset , if u have any other symptoms (SOB, increased heart rate) it is more likely that you have some degree of fluid overlaod from minor heart failure. The other thing to look for is kidney failure. You need to have bloods to get this checked. Just a little tip: if you put your legs up higher than your heart at around 6 pm you will drain off most the fluid and pee it out and that way you dont end up getting up all night once you put you legs up when you go to bed!) I hope you feel better soon. Go see your doctor as soon as possible..it is not an emergency but could get serious quickly. Isnt it terrible being an RN and being unwell - we make TERRILE patients - everything we learn just goes out the window and i need to be treated like a child. Goodluck

pitting edema is a dangerous sign of congested heart failure. fluid backs up into the plural spaces and distal areas of the heart because the heart is unable to take on all the back-up pressure from inadequate circulation. if you take your hand and push on the edema, and it takes more than 4 seconds to return to its normal position. you need to see a doctor and have your heart and lungs looked at. this is a serious early sign of CHF.

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