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Cited by 112Heart Failure Treatment and ManagementCardiovascular Function and Risk FactorsElectrolyte and hormonal disorders

Causes and treatment of oedema in patients with heart failure

Clark, Andrew L., Cleland, John G. F.·2013·Nature Reviews Cardiology
DOI 10.1038/nrcardio.2012.191
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Abstract

Oedema is one of the fundamental features of heart failure, but the pathophysiology of oedema varies. Patients present along a spectrum ranging from acute pulmonary oedema to gross fluid retention and peripheral oedema (anasarca). In patients with pure pulmonary oedema, the problem is one of acute haemodynamic derangement; the patient does not have excess fluid, but pulmonary venous pressure rises such that the rate of fluid transudation into the interstitium of the lung exceeds the capacity of the pulmonary lymphatics to drain away the fluid. Conversely, in patients with peripheral oedema, the problem is one of fluid retention. Understanding the causes of oedema will enable straightforward, correct management of the condition. For patients with acute pulmonary oedema, vasodilatation is important to reduce cardiac filling pressures. For patients with fluid retention, removing the fluid, using either diuretics or mechanical means, is the most important consideration.

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Crossref · 10.1038/nrcardio.2012.191

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189 of 189 references verified0 citation errors · 0 not checkable

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  • Many patients have little appreciation of the significance or the knowledge of how to adjust their diuretic dose.

    “Many patients have little appreciation of the significance or the knowledge of how to adjust their diuretic dose. 63 , 78 , 79”

    From Prioritizing symptom management in the treatment of chronic heart failure (2020) · cites this paper as [78]

  • Peripheral oedema is normally a result of right-sided heart congestion and can range from mild episodic ankle swelling to severe generalized fluid retention.

    “It is normally a result of right‐sided heart congestion and can range from mild episodic ankle swelling to severe generalized fluid retention. 78”

    From Prioritizing symptom management in the treatment of chronic heart failure (2020) · cites this paper as [78]

  • Patients often fail to appreciate mild peripheral oedema due to its insidious development and mistake it for normal weight gain, such that oedema may not be reported until 20 L of fluid has accumulated.

    “Unfortunately, patients often fail to appreciate mild peripheral oedema due to its insidious development and mistake it for normal weight gain 63 , 78 such that oedema may not be reported until 20 L of fluid has accumulated.”

    From Prioritizing symptom management in the treatment of chronic heart failure (2020) · cites this paper as [78]

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Authors
Clark, A. L., & Cleland, J. G. F.
Affiliations
University of Hull (GB)
Corresponding author
Clark, Andrew L.
ORCID
Venue
Nature Reviews Cardiology
Publisher
Springer Science and Business Media LLC
Published
2013-01-15
Volume
10
Issue
3
Pages
156-170
ISSN
  • 1759-5002 (ISSN-L)
  • 1759-5010
DOI
10.1038/nrcardio.2012.191
OpenAlex
W2065147095
Cited by
112
References
189
Citations by year
2026: 6 · 2025: 12 · 2024: 14 · 2023: 12 · 2022: 12 · 2021: 6 · 2020: 6 · 2019: 8 · 2018: 8 · 2017: 5 · 2016: 7 · 2015: 6 · 2014: 7 · 2013: 3
FWCI
1.30
Type
journal article
Language
en
Open access
closed
Licence
Locations
  • Nature Reviews Cardiology (publishedVersion)
  • PubMed (publishedVersion)
Funders
National Institute for Health and Care Research (NF-SI-0611-10227)
Topics
  • Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Heart Failure Treatment and Management
  • Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiovascular Function and Risk Factors
  • Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Electrolyte and hormonal disorders
Keywords
heart failure, pulmonary edema, peripheral edema, anasarca, pulmonary venous pressure, fluid retention, vasodilators, diuretics
MeSH terms
Aged, Capillary Permeability, Edema, Female, Heart Failure, Hemodynamics, Humans, Male, Prognosis, Pulmonary Edema, Risk Factors, Water-Electrolyte Balance

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