L. Indumathi

Nurse Educator, Department of Nursing, Kauvery Hospital, Salem

Correspondence: [email protected]

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Diagnostic Image

What is your diagnosis?

Answer: Moderate pitting edema of both lower limb of about 4mm depression.

Pitting edema occurs when excess fluids build up in the body, causing swelling; when pressure is applied to the swollen area, a “pit”, or indentation, will remain. Although it can affect any part of the body, it usually occurs in legs, feet, and ankles.

Pitting edema can be caused by various factors and conditions. In this case scenario the cause for the pitting edema is Left ventricular heart failure with diastolic dysfunction.

Heart failure occurs when the heart cannot pump blood to the rest of the body as well as it should. Here, the left ventricle is affected. It becomes stiffer than normal, and because of that the heart does not relax the way it should. Such diastolic heart failure can lead to fluid build-up in the lungs as well, causing pulmonary edema, which may lead to shortness of breath.

Elevated left atrial pressures lead to raised pulmonary artery pressures . Eventually right heart failure also follows. fluids may build up in the lower limbs and cause peripheral edema. In some cases, such congestive heart failure may also cause abdominal edema, also known as ascites.

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