Edema

Abstract

Edema is the accumulation of excessive fluid in the interstitial space. Edema is a common manifestation of many disease states and can be localized or generalized. Common causes of localized edema include deep vein thrombosis, cellulitis, chronic venous insufficiency, and lymphedema. Systemic conditions leading to edema include cardiac, liver, renal, and thyroid disease, most of which are associated with aberrant salt and water retention by the kidneys. A thorough history and physical examination are essential. The management depends on the underlying etiology and includes lifestyle and dietary modification in conjunction with pharmacotherapy. For those with chronic venous insufficiency, mechanical therapies such as leg elevation and compression stockings, along with judicious diuretic therapy, are useful. Deep venous thrombosis is treated with anticoagulation and cellulitis, with antibiotics. In medication-induced edema, the culprit medication should be discontinued or dose reduced. In those with heart failure, cirrhosis, or nephrotic syndrome, salt restriction and cautious use of diuretics can be initiated.