Skip to main content
Erschienen in: Zeitschrift für Gerontologie und Geriatrie 1/2015

01.01.2015 | Übersichten

Bilateral leg edema in an older woman

verfasst von: H.W. Thaler, M.D., S. Pienaar, G. Wirnsberger, R.E. Roller-Wirnsberger

Erschienen in: Zeitschrift für Gerontologie und Geriatrie | Ausgabe 1/2015

Einloggen, um Zugang zu erhalten

Abstract

Bilateral leg edema is a frequent symptom in older people and an important concern in geriatric medicine. Further evaluation is frequently not performed and simple therapy with diuretics is prescribed. Particularly in older patients, long-term use of diuretics can lead to severe electrolyte imbalances, volume depletion, and falls.
In this case report we want to focus the physicians’ attention on the necessity to determine the cause and show a correspondingly effective treatment for bilateral leg edema in older people. A thorough approach is required to recognize diseases and to avoid adverse drug events as geriatric patients often show an atypical presentation or minor symptoms. The cause of swollen legs is often multifactorial; therefore, the patient’s individual history and an appropriate physical examination are important. Depending on the clinical symptoms, evaluation including basic laboratory tests, urinalysis, chest radiography, and echocardiogram may be indicated.
The most probable cause of bilateral edema in older patients is chronic venous insufficiency. Heart failure is also a common cause. Other systemic causes such as renal disease or liver disease are much rarer. Antihypertensive and anti-inflammatory drugs can frequently cause leg edema, but the incidence of drug-induced leg swelling is unknown. With the help of this special case we tried to develop an approach to the diagnosis of symmetric leg edema in older patients, a problem frequently neglected in geriatric medicine.
Literatur
1.
Zurück zum Zitat Maisel AS, Krishnaswamy P, Nowak RM et al (2002) Rapid measurement of B-type natriuretic peptide in the emergency diagnosis of heart failure. N Engl J Med 347:161–167PubMedCrossRef Maisel AS, Krishnaswamy P, Nowak RM et al (2002) Rapid measurement of B-type natriuretic peptide in the emergency diagnosis of heart failure. N Engl J Med 347:161–167PubMedCrossRef
2.
Zurück zum Zitat Betti I, Castelli G, Barchielli A et al (2009) The role of N- terminal PRO-brain natriuretic peptide and echocardiography for screening asymptomatic left ventricular dysfunction in a population at high risk for heart failure. The PROBE-HF study. J Card Fail 15:377–384PubMedCrossRef Betti I, Castelli G, Barchielli A et al (2009) The role of N- terminal PRO-brain natriuretic peptide and echocardiography for screening asymptomatic left ventricular dysfunction in a population at high risk for heart failure. The PROBE-HF study. J Card Fail 15:377–384PubMedCrossRef
3.
Zurück zum Zitat Ely JW, Osheroff JA, Chambliss ML et al (2006) Approach to leg edema of unclear etiology. J Am Board Fam Med 19:148–160PubMedCrossRef Ely JW, Osheroff JA, Chambliss ML et al (2006) Approach to leg edema of unclear etiology. J Am Board Fam Med 19:148–160PubMedCrossRef
4.
Zurück zum Zitat Vassalotti JA, Stevens LA, Levey AS (2007) Testing for chronic kidney disease: a position statement from the National Kidney Foundation. Am J Kidney Dis 50:169–180PubMedCrossRef Vassalotti JA, Stevens LA, Levey AS (2007) Testing for chronic kidney disease: a position statement from the National Kidney Foundation. Am J Kidney Dis 50:169–180PubMedCrossRef
7.
8.
Zurück zum Zitat Frishman WH (2002) Effects of nonsteroidal anti-inflammatory drug therapy on blood pressure and peripheral edema. Am J Cardiol 89:18–25CrossRef Frishman WH (2002) Effects of nonsteroidal anti-inflammatory drug therapy on blood pressure and peripheral edema. Am J Cardiol 89:18–25CrossRef
10.
Zurück zum Zitat Rosendahl FR, Hycklama Vlieg A van, Doggen C (2007) Venous thrombosis in the elderly. J Thromb Haemost 5:310–317CrossRef Rosendahl FR, Hycklama Vlieg A van, Doggen C (2007) Venous thrombosis in the elderly. J Thromb Haemost 5:310–317CrossRef
Metadaten
Titel
Bilateral leg edema in an older woman
verfasst von
H.W. Thaler, M.D.
S. Pienaar
G. Wirnsberger
R.E. Roller-Wirnsberger
Publikationsdatum
01.01.2015
Verlag
Springer Berlin Heidelberg
Erschienen in
Zeitschrift für Gerontologie und Geriatrie / Ausgabe 1/2015
Print ISSN: 0948-6704
Elektronische ISSN: 1435-1269
DOI
https://doi.org/10.1007/s00391-013-0557-x

Weitere Artikel der Ausgabe 1/2015

Zeitschrift für Gerontologie und Geriatrie 1/2015 Zur Ausgabe

Mitteilungen des Bundesverbands Geriatrie

Mitteilungsseiten des BV Geriatrie

Journal Club

Journal Club

Editorial

Assessment I

Beiträge zum Themenschwerpunkt

Motor cognitive dual tasking