Anasarka - Causes, Symptoms And Treatment Of Anasarka

2024 Author: Josephine Shorter | [email protected]. Last modified: 2024-01-07 17:49

Causes, symptoms and treatment of anasarka

Content:

• What is anasarka?
• Causes of anasarka
• Anasarka symptoms
• Anasarka treatment

What is anasarka?

Anasarka is an extreme degree of edematous syndrome, characterized by pronounced fluid retention in the tissues and cavities of the body:

• Shins, feet and thighs;
• Torso
• Genital organs;
• Upper limbs;
• Face and neck;
• Lungs and pleural cavity;
• Pericardial cavity;
• Abdominal cavity.

The term anasarca was introduced specifically to emphasize the critical state of the body that requires urgent action. Diffuse edema of peripheral tissues does not pose an immediate threat to the body. The accumulation of fluid in cavities (polyserositis) is not so harmless, since a large amount of it disrupts the functioning of internal organs caused by their compression. Particularly dangerous in this respect is the compression of the lungs and the diaphragm with a decrease in respiratory excursion, which causes ventilation failure and increased hypoxia.

Anasarka is a natural consequence of the decompensated pathology of the body. Retaining fluid in peripheral tissues, he tries to relieve the heart from excessive loads by the type of a kind of a protective mechanism, signaling the presence of danger!

Causes of anasarka

The mechanisms of tissue impregnation with fluid from the vascular space can be associated with:

• An increase in the hydrostatic pressure of blood on the vascular wall;
• Stagnation of blood in the vascular bed;
• Fragility and increased permeability of the vascular wall;
• Decrease in oncotic and osmotic pressure of plasma;
• Redistribution of the ionic composition of blood and intercellular fluid in the form of sodium retention in tissues.

The listed mechanisms can work in such diseases:

• Decompensated heart disease with severe congestive heart failure (heart attack, myocarditis, various types of cardiomyopathies, cardiac arrhythmias, and others);
• Diseases of the kidneys and excretory system, accompanied by renal failure or impaired urodynamics and outflow of urine (nephrotic and nephritic syndromes in glomerulonephritis, pyelonephritis, urolithiasis, renal amyloidosis);
• Endocrine pathology in the form of hypothyroidism. The critical form of this disease is called myxedema. It ends with a sharp decrease in plasma protein levels, which causes fluid loss due to osmotic leakage into the tissue;

• Hyperaldosteronism. All diseases of the adrenal glands, accompanied by an increase in the synthesis of mineralocorticoids (aldosterone), cause electrolyte disturbances in the body in the form of sodium retention with its concentration in the intercellular space, which leads to an increase in osmotic pressure relative to plasma;
• Allergic reactions. They very rarely cause anasarca, which grows with lightning speed and is called Quincke's edema. Swelling of the airways (larynx) becomes especially dangerous.

Anasarka symptoms

The clinical picture of the anasarka can develop gradually or progressively. In most cases, you have to deal with the first variant of the disease.

At the same time, it is noted:

1. Edematous syndrome. It consists in widespread severe edema of all segments of the body. First, the legs and feet swell. In people with renal disease, the primary spread of edema from the face and upper extremities is possible. Over time, the genitals and trunk swell. You can confirm the presence of tissue edema by pressing on them with your finger. The deeper the trace after this, the more pronounced the edematous syndrome;
2. Dyspnea. With anasarka, it always arises. It is caused by the accumulation of fluid in the pleural cavity (hydrothorax) and its stagnation in the pulmonary circulation. It does not manifest itself for a long time, arising only with pronounced compression of both lungs. Patients should be alarmed by symptoms in the form of a feeling of lack of air during exertion, which gradually decrease to shortness of breath at rest;
3. Cardiomegaly. With anasarca of cardiac origin, a sharply enlarged heart is always recorded. This is a consequence of myocardial hypertrophy and fluid accumulation in the pericardial cavity.

Anasarka treatment

The possibilities and volumes of therapeutic measures for anasarca depend on the cause of its occurrence. In no case should you:

• Flood the body;
• Take products containing sodium;
• Do not act in terms of assistance.

Treatment for anasarka should include:

1. Dehydration of the body. It is achieved by intensive intravenous diuretic therapy with loop diuretics in high doses (Trifas, Lasix, Furosemide). Anasarkas are prescribed in all cases, regardless of origin;
2. Cardioprotective therapy. With cardiac pathology, it is imperative to strengthen the heart muscle. This can help cardiac glycosides (digoxin, strophanthin, korglikon) and metabolic drugs (mildronate, metamax, ATP);
3. Hemodialysis and plasma ultrafiltration. Shown with anasarca of renal origin. Such measures may be the only way out of this situation;
4. Glucocorticoids and antihistamines (dexamethasone, methylprednisolone, tavegil, suprastin). Shown with anasarca of allergic origin. Hormones can be used as membrane stabilizers of the vascular walls and for other types of anasarca;
5. Increased plasma oncotic pressure. Necessarily required for myxedema. Achieved by infusion of plasma and albumin. In the future, hormone replacement therapy with L-thyroxine is prescribed.

Congestive heart failure is by far the most common cause of anasarca. Every patient with cardiac pathology should monitor their condition in order to prevent its occurrence!

Author of the article: Lebedev Andrey Sergeevich | Urologist

Education: Diploma in the specialty "Andrology" received after completing residency at the Department of Endoscopic Urology of the Russian Medical Academy of Postgraduate Education in the urological center of the Central Clinical Hospital No. 1 of JSC Russian Railways (2007). Postgraduate studies were completed here by 2010.