Bilateral leg edema in an older woman

详细信息    查看全文

• 作者：H.W. Thaler M.D. (1)
  S. Pienaar (1)
  G. Wirnsberger (2)
  R.E. Roller-Wirnsberger (2)
  
  1. AUVA Trauma Center Meidling ; Kundratstr. 37 ; 1120 ; Vienna ; Austria
  2. Department of Internal Medicine ; Medical University of Graz ; Graz ; Austria
  
• 关键词：Venous insufficiency ; Geriatrics ; Heart failure ; Adverse drug events ; Non ; steroidal anti ; inflammatory agents ; Ven枚se Insuffizienz ; Geriatrie ; Herzinsuffizienz ; Nebenwirkungen von Medikamenten ; Nichtsteroide Entz眉ndungshemmer
• 刊名：Zeitschrift f篓鹿r Gerontologie und Geriatrie
• 出版年：2015
• 出版时间：January 2015
• 年：2015
• 卷：48
• 期：1
• 页码：49-51
• 全文大小：174 KB
• 参考文献：1. Maisel AS, Krishnaswamy P, Nowak RM et al (2002) Rapid measurement of B-type natriuretic peptide in the emergency diagnosis of heart failure. N Engl J Med 347:161鈥?67 g/10.1056/NEJMoa020233" target="_blank" title="It opens in new window">CrossRef
  2. Betti I, Castelli G, Barchielli A et al (2009) The role of N- terminal PRO-brain natriuretic peptide and echocardiography for screening asymptomatic left ventricular dysfunction in a population at high risk for heart failure. The PROBE-HF study. J Card Fail 15:377鈥?84 g/10.1016/j.cardfail.2008.12.002" target="_blank" title="It opens in new window">CrossRef
  3. Ely JW, Osheroff JA, Chambliss ML et al (2006) Approach to leg edema of unclear etiology. J Am Board Fam Med 19:148鈥?60 g/10.3122/jabfm.19.2.148" target="_blank" title="It opens in new window">CrossRef
  4. Vassalotti JA, Stevens LA, Levey AS (2007) Testing for chronic kidney disease: a position statement from the National Kidney Foundation. Am J Kidney Dis 50:169鈥?80 g/10.1053/j.ajkd.2007.06.013" target="_blank" title="It opens in new window">CrossRef
  5. Cho S, Atwood JE (2002) Peripheral edema. Am J Med 113:580鈥?86 g/10.1016/S0002-9343(02)01322-0" target="_blank" title="It opens in new window">CrossRef
  6. Topham EJ, Mortimer PS (2002) Chronic lower limb oedema. Clin Med 2:28鈥?1 g/10.7861/clinmedicine.2-1-28" target="_blank" title="It opens in new window">CrossRef
  7. Niemeyer NV, Janney LM (2002) Thiazolidinedione-induced edema. Pharmacotherapy 22:924鈥?29 g/10.1592/phco.22.11.924.33626" target="_blank" title="It opens in new window">CrossRef
  8. Frishman WH (2002) Effects of nonsteroidal anti-inflammatory drug therapy on blood pressure and peripheral edema. Am J Cardiol 89:18鈥?5 g/10.1016/S0002-9149(02)02233-6" target="_blank" title="It opens in new window">CrossRef
  9. Mortimer PS (2000) Swollen lower limb-2. BMJ 320:1527鈥?529 g/10.1136/bmj.320.7248.1527" target="_blank" title="It opens in new window">CrossRef
  10. Rosendahl FR, Hycklama Vlieg A van, Doggen C (2007) Venous thrombosis in the elderly. J Thromb Haemost 5:310鈥?17 g/10.1111/j.1538-7836.2007.02489.x" target="_blank" title="It opens in new window">CrossRef
  
• 刊物主题：Geriatrics/Gerontology; Internal Medicine; Aging; Social Sciences, general;
• 出版者：Springer Berlin Heidelberg
• ISSN：1435-1269

文摘

Bilateral leg edema is a frequent symptom in older people and an important concern in geriatric medicine. Further evaluation is frequently not performed and simple therapy with diuretics is prescribed. Particularly in older patients, long-term use of diuretics can lead to severe electrolyte imbalances, volume depletion, and falls. In this case report we want to focus the physicians鈥?attention on the necessity to determine the cause and show a correspondingly effective treatment for bilateral leg edema in older people. A thorough approach is required to recognize diseases and to avoid adverse drug events as geriatric patients often show an atypical presentation or minor symptoms. The cause of swollen legs is often multifactorial; therefore, the patient鈥檚 individual history and an appropriate physical examination are important. Depending on the clinical symptoms, evaluation including basic laboratory tests, urinalysis, chest radiography, and echocardiogram may be indicated. The most probable cause of bilateral edema in older patients is chronic venous insufficiency. Heart failure is also a common cause. Other systemic causes such as renal disease or liver disease are much rarer. Antihypertensive and anti-inflammatory drugs can frequently cause leg edema, but the incidence of drug-induced leg swelling is unknown. With the help of this special case we tried to develop an approach to the diagnosis of symmetric leg edema in older patients, a problem frequently neglected in geriatric medicine.