Edema

Acute Onset

• Cardiovascular

  • Heart failure

  • Deep venous thrombosis

  • Sepsis

    • Cardiogenic shock

    • Distributive shock

• Nephrotic syndrome:

  • Patient with h/o renal disease presents with new onset dyspnea and foamy urine

  • Spot urine protein:urine creatinine ratio > 3.5 confirms diagnosis

  • Refer to nephrology

• Angioedema: Bradykinin vs. histamine mediated

Chronic

• Cardiovascular (hydrostatic)

  • Heart failure

  • Aortic stenosis: Obtain echocardiogram and evaluate for

    • Congenital abnormality (e.g. bicuspid valve)

    • Rheumatic valve disease

    • Chronic valve calcification

  • Venous insufficiency

  • Pelvic compression (e.g. neoplasm): Abdominal U/S vs. CT

• Hepatorenal (oncotic +/- hydrostatic)

  • Cirrhosis

  • Hepatorenal syndrome

  • Renal disease (see nephrotic syndrome above)

• Lymphedema

  • Chronic lymphedema

  • Myxedema due to hypothyroidism

• Hyponatremia