MITRAL STENOSIS (MS)
Etiology:Most commonly rheumatic, although history of acute rheumatic feverMITRAL REGURGITATION (MR)
Etiology Rheumatic heart disease in ~33% of patients with chronic MR. OtherLV
Echocardiogram Enlarged LA, hyperdynamic LV
EDEMA
Edema occurs due to accumulation of fluid in interstitial spaces, namely the subcutaneous cellular tissue, serum or spaces cavities interstitial fluid of viscerelor.Acumularea can appreciate only by increasing body weight or diuresis may follow up to an amount of 7-9 liters. Initially the swelling is the retention inaparent. Installing clinical swelling appears at the latch of the body or in areas with lax subcutaneous tissue, depending on the position in May extended the patient. In advanced stages including generalized edema is the ultimate seroasele: pericardial cavity (hidropericard), pleural cavity (hydrothorax), peritoneal cavity (ascites), joint cavity (hidartroze). Fluid retention in all these areas is called anasarca.
The diagnosis of edema is on inspection and palpation is necessary other specialized tests depending on the type and location of edema and laboratory investigations. The investigation is important to distinguish the type of reaction Rivalta nature of transudat edema (protein content less than 2g% - Rivalta negative) exudate (protein content greater than 2g% - Rivalta positive).
Other investigations: proteinemie, electrophoresis, determination of albumin, ionogramă, arterial blood oxygen saturation, cholesterol, hormone tests, kidney tests, etc..
They have different causes and mechanisms.
The diagnosis of edema is on inspection and palpation is necessary other specialized tests depending on the type and location of edema and laboratory investigations. The investigation is important to distinguish the type of reaction Rivalta nature of transudat edema (protein content less than 2g% - Rivalta negative) exudate (protein content greater than 2g% - Rivalta positive).
Other investigations: proteinemie, electrophoresis, determination of albumin, ionogramă, arterial blood oxygen saturation, cholesterol, hormone tests, kidney tests, etc..
They have different causes and mechanisms.
Cardiac edema
Cardiac edema is produced by increasing hydrostatic pressure in blood vessels by venous stasis, increasing capillary permeability and decreased glomerular filtrate by decreasing cardiac output. All these mechanisms result in water and sodium retention in circulation and accumulation of fluid in interstitial spaces.
Because cardiac edema occur first in areas of the body latch (maleolar, pretibial, the back of the thighs, sacral region, where lie flat dorsal) their occurrence is related to the position of a patient preference. Edema heart is reduced or absent in the morning, changing into the day being marked Vesper. As cronical disease, edema becomes permanent changes during the day and by patient position.
Initially, cardiac edema is soft, symmetrical, with cold skin, painful and leaves well at moderate digital pressure, and as the skin becomes cyanotic the edema is harder.
Kidney edema
Renal edema occurs in various renal diseases such as nephrotic syndrome.
Edema in glomerulonephritis occurs by decreasing glomerular filtration and sodium and water retention, while the nephrotic syndrome by lowering serum proteins, following their elimination in the urine increased.
Renal edema occurs in areas with lax tissue (face, eyelids), and in the interstices and HIV. Is more pronounced in the morning on awakening, soft, well leave no digital pressure and skin edemaţiate areas are pale (white and fluffy edema) .
Cardiac edema is produced by increasing hydrostatic pressure in blood vessels by venous stasis, increasing capillary permeability and decreased glomerular filtrate by decreasing cardiac output. All these mechanisms result in water and sodium retention in circulation and accumulation of fluid in interstitial spaces.
Because cardiac edema occur first in areas of the body latch (maleolar, pretibial, the back of the thighs, sacral region, where lie flat dorsal) their occurrence is related to the position of a patient preference. Edema heart is reduced or absent in the morning, changing into the day being marked Vesper. As cronical disease, edema becomes permanent changes during the day and by patient position.
Initially, cardiac edema is soft, symmetrical, with cold skin, painful and leaves well at moderate digital pressure, and as the skin becomes cyanotic the edema is harder.
Kidney edema
Renal edema occurs in various renal diseases such as nephrotic syndrome.
Edema in glomerulonephritis occurs by decreasing glomerular filtration and sodium and water retention, while the nephrotic syndrome by lowering serum proteins, following their elimination in the urine increased.
Renal edema occurs in areas with lax tissue (face, eyelids), and in the interstices and HIV. Is more pronounced in the morning on awakening, soft, well leave no digital pressure and skin edemaţiate areas are pale (white and fluffy edema) .
Hepatitis edema
Liver swelling occurs in chronic active hepatitis and decompensated liver cirrhosis and is vascular mechanism: decreased liver synthesis of albumin in hypoalbuminaemia, which decreases the coloidosmotic pressure plasma and increased hydrostatic pressure in the portal vein (portal hypertension with ascites development). Depending on the quantity of ascites fluid is compressed inferior vena cava causing edema latch. The appearance of edema is similar to that of cardiac edema.
Venous edema
Edema due to venous obstruction of a vein is followed by increased venous pressure in the territory, the dysfunction of venous valves or by decreasing muscle activity in a particular segment of the body.
Appearance of venous edema is located with cyanotic skin corresponding blocked vein. The best known aspects of venous edema include: swelling of the lower limb thrombophlebitis, which can be olso bilateral edema caused by increased pressure in the vena cava inferior (by pregnancy, giant ovarian cyst, ascites, pelvic tumors), edema in the upper cave vein compression edema called "the mantle", located on the face, neck, upper chest region and upper limbs, caused by the presence of benign or malignant mediastinal tumors. Appearance of venous edema is usually unilateral, depending on the territory of vein tablets cyanotic skin, hot and painful compression.
Edema of venous thrombophlebitis is similar localized inflammatory edema and may be followed due to circulatory problems associated pressure and the occurrence of varicose ulcers. Edema due to upper or lower cave compresiunii veins have the appearance of cardiac edema.
Lymphatic edema
Lymph edema is due the obstruction of a lymphatic vessel leading to lymph stasis and increased the coloid osmotic pressure in interstitial spaces, which is higher than in plasma. So lymphatic edema is unilaterally or blocked tributary territory, is a persistent swelling, hard and leaves well. It is most common in secondary lymphatic circulation adenopathy massive block, axillary or groin, in case of malignant lymphoma and breast and pelvic neoplasms. If swelling is massive, particularly in the lower limbs called elephantiasis.
Endocrine edema
Glandular swelling appears in some endocrine diseases among which hypothyroidism, secondary hyperaldosteronism of cardiac disease, renal or liver and hiperfolliculinemia. In general, endocrine edema is generalized, white and leaves well.
Edema of mixed appearance is rough, most obvious in the face (facies mixedematos) with a tendency to generalize, with pale skin and dry.
Edema of hyperaldosteronism secondary characters swelling caused by water and sodium retention, edema was similar in basic diseases, heart, kidney or liver.
Flammable edema
Inflammatory edema occurs through the release of vasoactive substances in circulation (bradykinin and histamine) by vasodilation and increased capillary permeability and protein extravasation followed by increased coloidosmoti pressure in related interstitial spaces.
This type of edema occurs in cases of superficial inflammation (abscess, phlegmon, boil) and has classic characters: painful, red, warm and soft. Inflammatory edema is described above profound inflammation with effusion: perirenal abscess, lung abscess, liver abscess, etc..
Run edema(alergic)
Allergic edema in case of allergic reaction of the organism in the presence of food grade substances or medicines or following insect bites or animal bites. In all these cases serve as allergenic substances and produce an antigen-antibody reaction with the development of vasodilatation and increased capillary permeability, accumulation of fluid in the interstitial cavities.
Allergic swelling occurs in the eyelids, lips, tongue, is painless, soft, white or pink, erythematous, pruritic and transient. Edema is a life-threatening head with glottis edema and Quincke edema called.
If swelling occurs secondary to insect bites (spider) or animal bites (snake or snake venom) is localized swelling, red, painful, hot and itchy.
Engioedema
Angioedema occurs in cases of neurological disease followed by hemiplegia. Edema occurs as a result of vasomotor disturbances paralyzed area increases intracapilare pressure and capillary permeability.
He is a soft swelling, painless, persistent and without discoloration of skin.
Liver swelling occurs in chronic active hepatitis and decompensated liver cirrhosis and is vascular mechanism: decreased liver synthesis of albumin in hypoalbuminaemia, which decreases the coloidosmotic pressure plasma and increased hydrostatic pressure in the portal vein (portal hypertension with ascites development). Depending on the quantity of ascites fluid is compressed inferior vena cava causing edema latch. The appearance of edema is similar to that of cardiac edema.
Venous edema
Edema due to venous obstruction of a vein is followed by increased venous pressure in the territory, the dysfunction of venous valves or by decreasing muscle activity in a particular segment of the body.
Appearance of venous edema is located with cyanotic skin corresponding blocked vein. The best known aspects of venous edema include: swelling of the lower limb thrombophlebitis, which can be olso bilateral edema caused by increased pressure in the vena cava inferior (by pregnancy, giant ovarian cyst, ascites, pelvic tumors), edema in the upper cave vein compression edema called "the mantle", located on the face, neck, upper chest region and upper limbs, caused by the presence of benign or malignant mediastinal tumors. Appearance of venous edema is usually unilateral, depending on the territory of vein tablets cyanotic skin, hot and painful compression.
Edema of venous thrombophlebitis is similar localized inflammatory edema and may be followed due to circulatory problems associated pressure and the occurrence of varicose ulcers. Edema due to upper or lower cave compresiunii veins have the appearance of cardiac edema.
Lymphatic edema
Lymph edema is due the obstruction of a lymphatic vessel leading to lymph stasis and increased the coloid osmotic pressure in interstitial spaces, which is higher than in plasma. So lymphatic edema is unilaterally or blocked tributary territory, is a persistent swelling, hard and leaves well. It is most common in secondary lymphatic circulation adenopathy massive block, axillary or groin, in case of malignant lymphoma and breast and pelvic neoplasms. If swelling is massive, particularly in the lower limbs called elephantiasis.
Endocrine edema
Glandular swelling appears in some endocrine diseases among which hypothyroidism, secondary hyperaldosteronism of cardiac disease, renal or liver and hiperfolliculinemia. In general, endocrine edema is generalized, white and leaves well.
Edema of mixed appearance is rough, most obvious in the face (facies mixedematos) with a tendency to generalize, with pale skin and dry.
Edema of hyperaldosteronism secondary characters swelling caused by water and sodium retention, edema was similar in basic diseases, heart, kidney or liver.
Flammable edema
Inflammatory edema occurs through the release of vasoactive substances in circulation (bradykinin and histamine) by vasodilation and increased capillary permeability and protein extravasation followed by increased coloidosmoti pressure in related interstitial spaces.
This type of edema occurs in cases of superficial inflammation (abscess, phlegmon, boil) and has classic characters: painful, red, warm and soft. Inflammatory edema is described above profound inflammation with effusion: perirenal abscess, lung abscess, liver abscess, etc..
Run edema(alergic)
Allergic edema in case of allergic reaction of the organism in the presence of food grade substances or medicines or following insect bites or animal bites. In all these cases serve as allergenic substances and produce an antigen-antibody reaction with the development of vasodilatation and increased capillary permeability, accumulation of fluid in the interstitial cavities.
Allergic swelling occurs in the eyelids, lips, tongue, is painless, soft, white or pink, erythematous, pruritic and transient. Edema is a life-threatening head with glottis edema and Quincke edema called.
If swelling occurs secondary to insect bites (spider) or animal bites (snake or snake venom) is localized swelling, red, painful, hot and itchy.
Engioedema
Angioedema occurs in cases of neurological disease followed by hemiplegia. Edema occurs as a result of vasomotor disturbances paralyzed area increases intracapilare pressure and capillary permeability.
He is a soft swelling, painless, persistent and without discoloration of skin.
No comments:
Post a Comment