Swelling

How can I tell if swelling is cardiac?

Swelling is a common symptom often unrelated to illness. The volume of fluid in the human body changes often, for example in conjunction with women’s hormonal cycles, because approximately two-thirds of the normal body weight is water. Swelling occurs when venous pressure increases and fluid seeps into tissue. Swelling often precedes fluid accumulation in the body and weight gain. Heart failure, the heart’s deteriorated capacity to pump, causes additional fluid to accumulate in the body. Cardiac swelling involves other symptoms, such as shortness of breath and fatigue during exertion and findings such as increased jugular venous pressure and increased liver size. The symptoms of heart failure are easiest to detect in the lower extremities as a result of standing and sitting posture. Patients who are confined to bed may also have swelling in the pelvic area and back. In heart failure, swelling is evenly distributed in both lower extremities and is easiest to detect by pressing the front surface of the lower section of the shin bone. If additional fluid has accumulated in the tissue, pressing usually leaves an indentation that gradually disappears. Fluid may also accumulate in the abdominal cavity, and increased venous pressure in the intestines may cause bowel problems. Liver and kidney diseases and thyroid insufficiency are typical non‑cardiac illnesses, which often feature swelling. Swelling of the lower extremities may simply be due to obesity or to venous insufficiency, particularly in connection with long period of sitting. Venous circulation disturbances, lymphedema, low protein levels and medical substances, which cause the blood vessels to dilate also commonly cause swelling in the lower extremities. Sudden venous thrombosis is a severe condition that may underlie swelling. In that case, swelling is usually one‑sided.