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What Causes Heart Problems And Pedal Edema?

Posted on Fri, 16 Jan 2015

Question: 56 yo male w/ alcohol abuse PMH now w/ sudden bilat pitting pedal edema, No SOB, no Hx of heart problems, cirrhosis is mild ?????

Answered by Dr. Rakesh Madhyastha (3 hours later)

Brief Answer:
Could be due to Hypoalbuminemia ( low albumin).

Detailed Answer:
Hello,

Thanks for the query

From the history of alcohol abuse it looks like there might be some amount of low protein which is causing the pedal edema.

Here is what you should do

1. Approach a GP for liver function test, urine routine ( to look for loss of protein in urine), and thyroid function test.
2. Restrict fluid intake to less than 1.2 litres per day.
3. Get an ultra sound of the abdomen to look for cirrhosis of liver.
4. Elevating the leg end while sleeping at night ( keeping two pillows at the leg end ) is an easy way to reduce the edema.

I hope I was of help, if you have any further queries please get back to me.

Regards.

Above answer was peer-reviewed by : Dr. Ashwin Bhandari

Follow up: Dr. Rakesh Madhyastha (16 hours later)

THANK U VERY MUCH. YES, HIS NUTRITION IS TERRIBLE AND I KNOW HIS ALBUMIN WAS DOWN BELOW 1.9 WHEN HE WAS HOSPITALIZED. BUT THE SUDDEN ONSET OF IT IN <24-36 HRS IS WHAT HAS ME PUZZLED....

Answered by Dr. Rakesh Madhyastha (1 hour later)

Brief Answer:
Pedal edema

Detailed Answer:
Hello

Thanks for getting back

Sudden onset of bilateral pedal edema can happen if he has kept is leg down for prolonged period of time, for example while travelling or watching tv, etc. Low albumin is known to cause increased cholesterol and coagulation leading to DVT, please make sure he is on atorvastatin. I usually give my patients, Tab Atorvastatin once at night.

Regards

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Above answer was peer-reviewed by : Dr. Prasad