30yrs male swelling of both legs R>L. Since 4days no other complete no pallor no sob / urine problem /no htn dm .. now bp 160/110. PR 75 bmn. Tempr normal..



?Cardiac failure. Investigation &2decho..? Hypertension is at risk for heart failure, coronary artery disease, stroke and end-stage kidney disease and, according to the Disease Control and Prevention, nearly 1/3 of adults have hypertension, but only about 1/2 of them have their blood pressure controlled. Hypertension usually does not cause symptoms until it produces end-organ damage, which can involve eyes, heart, kidneys, nervous system or arteries. If people have high blood pressure, swelling, also called edema, in the feet and legs could be a sign of end-organ damage. Chronically high blood pressure places excess strain on heart, which may cause it to wear out and fail. Heart failure diminishes blood flow and in response, body tends to retain fluid in an effort to maintain adequate blood volume. But a failing heart is unable to accommodate this extra fluid, so it is transferred out of your blood vessels and into tissues -- usually in those body parts that are lower than others. So, edema in your legs and feet could be the result of heart failure caused by uncontrolled high blood pressure. Kidneys help control blood pressure by altering sodium and water absorption in response to changes in blood pressure. If blood pressure falls, kidneys absorb more salt and water to bring pressure back up. If. blood pressure climbs too high, kidneys compensate by excreting sodium and water to lower blood volume. High blood pressure damages the small arteries in kidneys and reduces their blood flow, leading them to react -- incorrectly -- as if blood pressure has fallen. Even though blood pressure is already too high, kidneys retain salt and water to increase your blood volume. This, in turn, causes volume overload, which leads to accumulation of excess fluid, which can cause edema in your legs and feet. Certain medications used to treat hypertension have a reputation for causing edema in the legs and feet. In particular, calcium channel blockers in the dihydropyridine class -- nifedipine , amlodipine& felodipine. for example -- are notorious for causing this swelling. Medication-induced swelling does not respond well to diuretics -- commonly knows as water pills -- so it can lead to unnecessary evaluations and treatments unless its underlying cause is suspected. In a person with high blood pressure, edema in the legs and feet could be a sign of serious end-organ damage, such as heart failure or end-stage kidney disease. On the other hand, the edema could also stem from disorders unrelated to blood pressure, such as liver disease, diabetes, damaged leg veins or blood clots in legs. Or it might simply be the result of sitting or standing for too long. Regardless of the underlying cause, if person have edema of the legs and feet that suddenly appears or that seems to be worsening, seek medical attention.

thank you sir

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I totally agree with Dr. SivanesanRamayya. Hypertension in an adult who is seeking medical attention either due to shortness of breath or leg swelling should be considered as a medical emergency. If left untreated they will have complications with end organ damage like stroke etc. complete evaluation is required regarding cardiac function, Renal and liver function and appropriate Rx should be initiated as early as possible. Lipid profile should be checked. Hypertension should be controlled.

Hi doctor, CCF, RENAL DYSFUNCTION, LIVER DYSFUNCTION, Any h/o related to above DYSFUNCTION s. Must look for hypoproteinemia, Severe anemia. Hypothyroidism will show pretibial edema.. B/L venous Doppler for insufficiency rare but if necessary..

edema due to many factors. dur to liver dysfunction heart dysfunction renal dysfunction anemia hypothyroidism. ..patient is hypertensive so most of the indicates about heart disease so rule out for proper diagnosis do ecg..nd further investigation


nephrotic syndrome r what is 2decho report if anaemia in these conditions pedal enema formed please full history of patient

In this case Nephrotic syndrome is more possible as such a short history and lack of SOB are against CCF. Anyway a simple complete urine examination may show proteinuria ...confirming.diagnosis

ccf, cofirm dx .doing 2Decho cardio graphy study.


in view of short duration of problem better to think of Acute nephritis better to start diuretic lndapamide 5mg OD and Beta blocker metoprolol50od then evaluate.

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