Page 299 - Concise Pathology for Exam Preparation ( PDFDrive )

284 SECTION II Diseases of Organ Systems

• Seen over dependent parts (gravity dependent) with sparing of face and arms
• In ambulatory patients, oedema is seen over the legs, particularly in the pretibial
region. It is less in the morning and more towards the evening. Oedema is sacral in
bedridden patients.
• In advanced stages cases, generalized oedema or anasarca may be seen.
• Nonspecific symptoms
• Anorexia, nausea, abdominal pain and fullness (congestion of liver and portal venous
system)
• Fatigue and weakness (reduced perfusion of skeletal muscles)
• Low-grade fever (reduced cutaneous flow)

Diagnosis
• Chest radiograph may show cardiomegaly, prominence of upper lobe veins, Kerley A
and B lines (cuffing of the areas around the bronchi) and other features of pulmonary
oedema.
• ECG to identify arrhythmias, ischaemic heart disease and right and left ventricular
hypertrophy
• Echocardiography for evaluation of ejection fraction, valvular status and chamber size.

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