Edema

Tropical Edema

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Tropical Edema, Heat Edema

  • See Also
  1. Heat Illness
  • Definitions
  1. Heat Edema
    1. Acute edema related to heat exposure
  • Epidemiology
  1. Occurs in non-acclimitized patients (esp. elderly)
  • Pathophysiology
  1. In warm environments, body shunts warm blood to periphery via peripheral vasodilation
  2. Also associated with salt or water retention from heat
  3. Increased peripheral fluid results in microvascular transudate
  4. Despite edema, patients are typically intravascularly volume depleted
  5. May be provoked by rapid transition from cold to hot environments
  • Symptoms
  1. Abdominal Bloating
  • Signs
  1. Weight gain up to 5 kg over several days
  2. Distribution
    1. Ankle edema (most common)
    2. Hand edema
  • Differential Diagnosis
  1. See Edema
  • Labs
  1. Serum Sodium decreased (Hyponatremia)
  • Management
  1. Move to cooler environment
  2. Elevate extremities
  3. Consider Compression Stockings
  4. Do NOT administer Diuretics (not helpful and potentially harmful in a volume depleted patient)
  • Course
  1. Onset within 48 hours of arriving in warm climate
  2. Resolves with acclimatization diuresis in a few days
  • References
  1. Salinas and Ruttan (2017) Crit Dec Emerg Med 31(9): 3-10
  2. Zink (2020) Crit Dec Emerg Med 34(3): 19-27