Study note

Differential diagnosis of peripheral oedema

THE CONTEXT

Peripheral oedema may arise from cardiac disease, venous or lymphatic disorders, hypoalbuminaemia, drugs or an idiopathic cause.

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Cardiac causes include right heart failure, combined left and right heart failure, pericardial constriction and cardiomyopathy.

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Chronic venous insufficiency associated with varicose veins is a cause of peripheral oedema.

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Chronic lymphatic obstruction is another cause.

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Nephrotic syndrome, liver disease and protein-losing enteropathy are listed causes of hypoalbuminaemic oedema.

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This oedema is often widespread and can involve the arms and face.

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Fludrocortisone and non-steroidal anti-inflammatory drugs cause oedema through sodium retention.

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Nifedipine and amlodipine are listed as causing oedema through increased capillary permeability.

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Idiopathic oedema is more common in women than men.

NEETx

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