This is a condition that arises when there is too much fluid in the tissue spaces or the cavities of the body and can result in congestion. In inflammation the fluid accumulation we see is normal, this is part of the process, where the fluid that is rich in protein goals to the area. This is different from non- inflammatory oedema, where the fluid accumulation not rich in protein. This is due to the osmotic and hydrostatic pressures between the blood, vessels, and tissue not functioning properly. Intravascular hydrostatic forces and interstitial osmotic forces will move fluid in and out of the blood vessels. Opposite to this is the osmotic pressure which pushes or pulls fluid in and out of vessels.
Oedema will happen when
- There is an increase in intravascular pressure, pushing the fluid out of the vessels into the interstitial area. This can be caused by poor venous flow especially in the lower limbs due to either a deep vein thrombosis. Also, increased venous pressure caused by congestive heart failure ( right ventricle), this also causes a reduction in blood flow to the kidney. This then leads to retention of sodium and water, which then leads to the increase in blood volume.
- There is a decrease in osmotic plasma pressure which is set by albumin produced by the liver. This is mainly caused by Kidney disease where albumin is excreted, meaning there is a reduction of flow through the kidney. Another disease that affects Osmotic pressure is Liver disease, Increase in portal hypertension causes an increase in hydrostatic pressure. This causes the fluid to leak out into the interstitial spaces, this causes a decrease in plasma volume which leads to reduced kidney perfusion.
- There is blockage of the lymph flow retention of salt and water. Oedema is usually localized and because of an inflammatory response, either a neoplasm or obstruction.
As a result of the left ventricular failure, blood returning to the heart from the lungs is slowed leading to a backup of blood in the lungs which results in congestion. This causes pressure in the capillaries to increase due to increased blood volume, this then causes bleeding into the alveolar spaces. Pulmonary oedema is a medical emergency and the outlook is dependent on whether the treatment was immediate. Conditions that contribute to heart-related pulmonary oedema.
- Coronary artery disease. This happens as a result of narrowing of the blood vessels that supply blood to the heart from fatty deposits or arteriosclerosis. A heart attack happens when there is a blockage in one of the narrowed arteries. This blocks blood flow to that area and causes damage to the heart muscle, meaning the heart cannot pump blood as well as it used to. The compensatory mechanism kick in but overtime they fail because of the increased workload. When the heart stops pumping blood frequently, blood eventually backs up into the lungs. This is what causes the blood to pass through the capillaries and into the air sacs, this is called chronic congestive failure.
- High blood pressure. Untreated hypertension is like a loop, hypertension causes microscopic breaks in the endothelial wall of the blood vessels. This leads to a clotting cascade, normal clotting cascade is tightly regulated, if this is unregulated this can cause the formation of thrombi. Thrombi can form anywhere in the cardiovascular system except the ventricles of the heart. Hypertension will over time cause the enlargement of the left ventricle due to the extra workload.
Symptoms of oedema include
- Swollen limbs
- Facial puffiness
- Abdominal bloating
- shortness of breath, extreme difficulty breathing, coughing up blood
- A sudden change in mental state or coma
- Muscle aches and pains
There are a number of treatment options for oedema, these include compression stockings around the limbs to force the body to reabsorbs the fluid. Doctors can also use pharmacological therapies like the use of diuretics. These diuretics reduce the blood volumes but they also deplete vitamins. Individuals can also help themselves by reducing the intake of food that are high in salt, exercise and generally adopting a healthy lifestyle. As we have looked at where ever salt goals, water follows as well. individuals can also eat food that are natural diuretics like asparagus, parsley, beets, grapes, green beans, leafy greens, pineapple, pumpkin, and onions to name a few.
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