[Edema in heart disease].
The two main causes of cardiac edema are congestive heart failure and pericardial diseases. Careful evaluation of patients with edema is important because there are many other diseases showing the symptom. Important for the treatment of edema is to restrict sodium and water intake. Diuretics and digoxin have formed the mainstay of treatment for many years. Patients with edema should be given diuretics until an euvolemic state is achieved. Especially loop diuretic is effective to reduce edema quickly. Recently atrial natriuretic peptide and brain natriuretic peptide are shown to be useful markers to assess heart failure. These peptides are also useful as therapeutic tools for treating edema in heart failure. Even if the patient has responded favorably to diuretics, angiotensin converting enzymes inhibitors, angiotensin II receptor blockers, beta blockers and spironolactone should be added according to the status, because there are many evidences that they improve the long-term prognosis. Vasopeptidase inhibitors and vasopressin antagonist are being introduced for management of heart failure.
Muto
Shinsuke
S
Department of Cardiovascular Medicine, University of Tokyo, Graduate School of Medicine.
Hirata
Yasunobu
Y
D004487:Edema / Q000188:drug therapy / Q000209:etiology*; D006333:Heart Failure / Q000150:complications*; D006801:Humans