Tropical Edema

Sep 16, 2019 admin NHIỄM KHUẨN, TIM MẠCH 0

Tropical Edema

Aka: Tropical Edema, Heat Edema

II. Definition

  1. Acute edema related to heat exposure

III. Epidemiology

  1. More common in older patients

IV. Pathophysiology

  1. In warm environments, body shunts warm blood to periphery via peripheral vasodilation
  2. Increased peripheral fluid results in microvascular transudate
  3. Despite edema, patients are typically intravascularly volume depleted
  4. May be provoked by rapid transition from cold to hot environments

V. Symptoms

  1. Abdominal Bloating

VI. Signs

  1. Weight gain up to 5 kg over several days
  2. Distribution
    1. Ankle edema (most common)
    2. Hand edema

VII. Differential Diagnosis

  1. See Edema

VIII. Labs

  1. Serum Sodium decreased (Hyponatremia)

IX. Management

  1. Move to cooler environment
  2. Elevate extremities
  3. Do NOT administer Diuretics (not helpful and potentially harmful in a volume depleted patient)

X. Course

  1. Onset within 48 hours of arriving in warm climate
  2. Resolves with acclimatization diuresis in a few days

XI. References

  1. Salinas and Ruttan (2017) Crit Dec Emerg Med 31(9): 3-10

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