[Voice of Hope March 11, 2023](Editor: Li Wenhan) In life, we often see some elderly people with swollen legs and panting when walking, which is most likely due to heart failure. Swelling of the legs is a sign of edema. What should I do in the face of edema? How to treat.
Heart failure, as the name implies, is the failure of the heart. After the heart fails, the ability of the heart to eject blood will decrease. As a result, the blood in the heart cannot be discharged, and it becomes difficult for the blood in the veins to enter the heart. As a result, blood pressure pools in the veins. The blood stasis is too much, causing the water in the blood to run out of the blood vessels, causing edema.
For example, gastrointestinal congestion, leading to gastrointestinal edema, poor appetite and poor digestion ability of patients. Congestion in the lungs leads to pulmonary edema, and the patient becomes difficult to breathe. The most obvious of these is the lower extremities. Due to the effect of gravity, edema first occurs in the lowest parts of the body. Therefore, edema of the lower extremities is the most likely to occur.
In the face of edema, the most fundamental method is of course to cure heart failure, then the edema will naturally be resolved. However, heart failure cannot be cured at present, and only palliative measures can be taken.
Edema is actually the accumulation of water in the body. On the one hand, drink less water so that the water in the body will not increase further;
1. Limit water and sodium intake
The main source of sodium ions is table salt. In addition, some condiments in life, such as monosodium glutamate and soy sauce, contain sodium salt.
Sodium and water in the human body are basically in balance. For example, if our food is too salty, we need to drink water. This is due to too much sodium intake, so drink plenty of water to dilute the concentration of sodium salts.
Therefore, patients with heart failure should limit their sodium and water intake.
Of course, the restrictions here are mainly for patients with severe edema. Although some patients also have heart failure, they are in a stable period and their normal life is fine. Don’t be too restrictive.
Those who have swollen feet, those who wear clothes at night and lie unevenly, and who are panting following walking a few steps, are the ones who need to limit their water and sodium intake.
2. Drug treatment
Drugs that increase urination are also called diuretics in medicine. Diuretics are not a drug, but a class of drugs. Diuretics are the most effective drugs to eliminate edema.
Diuretics can be roughly divided into three categories:
1. Thiazide diuretics
Including hydrochlorothiazide, indapamide. The diuretic effect is relatively weak, suitable for people with mild edema, high blood pressure and good renal function.
2. Pan diuretics
Including furosemide, dragasemide, bumetanide. The diuretic effect is relatively strong, and it is suitable for most patients with heart failure, especially those with obvious edema. However, people with poor renal function should use it with caution.
3. Potassium-sparing diuretics
Includes spironolactone and eplerenone. The diuretic effect is also relatively weak. The biggest function is to preserve potassium and prevent the loss of potassium ions in the body with urine, while other diuretics excrete potassium.
Potassium ions are very important ions in the human body. Both low potassium and high potassium may be fatal for patients with heart failure.
This drug is often used together with other diuretics, so that potassium preservation and potassium excretion can counteract each other.
4. Vasopressin V2 receptor antagonists
The representative drug is tolvaptan. Strong diuretic effect, suitable for intractable edema or edema with low sodium in the body.
Usually following using the above three diuretics, if there is still no effect, tolvaptan can be added.
The most appropriate dose of diuretics is to reduce the weight by 1-2 catties per day. After the symptoms are relieved, you can consider using the smallest dose for long-term maintenance to prevent edema once more.
Summarize:
Edema is a typical symptom of heart failure. To treat edema, on the one hand, water and sodium intake should be reduced. On the other hand, diuretics can be used for treatment.
Editor in charge: Li Zhi
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