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Nat Rev Cardiol. 2013 Mar;10(3):156-70. doi: 10.1038/nrcardio.2012.191. Epub 2013 Jan 15.

Causes and treatment of oedema in patients with heart failure.

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1
Department of Cardiology, Hull York Medical School, University of Hull, Castle Hill Hospital, Cottingham HU16 5JQ, UK. a.l.clark@hull.ac.uk

Abstract

Oedema is one of the fundamental features of heart failure, but the pathophysiology of oedema varies. Patients present along a spectrum ranging from acute pulmonary oedema to gross fluid retention and peripheral oedema (anasarca). In patients with pure pulmonary oedema, the problem is one of acute haemodynamic derangement; the patient does not have excess fluid, but pulmonary venous pressure rises such that the rate of fluid transudation into the interstitium of the lung exceeds the capacity of the pulmonary lymphatics to drain away the fluid. Conversely, in patients with peripheral oedema, the problem is one of fluid retention. Understanding the causes of oedema will enable straightforward, correct management of the condition. For patients with acute pulmonary oedema, vasodilatation is important to reduce cardiac filling pressures. For patients with fluid retention, removing the fluid, using either diuretics or mechanical means, is the most important consideration.

PMID:
23319101
DOI:
10.1038/nrcardio.2012.191
[Indexed for MEDLINE]
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