Anasarca

Anasarca is a severe and generalized form of edema, with subcutaneous tissue swelling throughout the body. Unlike edema, which almost everyone will experience at some time and can be relatively benign, Anasarca is a pathological process reflecting a severe disease state and can involve the cavities of the body in addition to the tissues.

Signs and symptoms

physical appearance

Can include: · periorbital edema "eye puffiness" · perioral edema · upper extremity edema · ascites · lower extremity edema · pre-tibial edema · pedal edema

physical manifestations

Can include: · impaired vision, difficulty opening eyes · shortness of breath (SOB), dyspnea on exertion (DOE), orthopnea · chest pain · extreme discomfort · debilitation

Cause

Causes include liver failure, kidney failure, right-sided heart failure, nephrotic syndrome, protein-losing enteropathies, severe protein deficiency, and capillary leak syndrome. Anasarca is often caused by a decreased oncotic pressure. It can also be caused by the administration of exogenous intravenous fluid. In Hb Barts, the high oxygen affinity results in poor oxygen delivery to peripheral tissues, resulting in anasarca.

Diagnosis

Anasarca is a diagnosis made clinically and differentiated from edema by extent of body involvement and severity. While edema is usually graded on mild/moderate/severe scale and usually affects 1-2 regions of the body, Anasarca affects the whole body and is the most severe form of edema with subcutaneous tissue swelling from head to feet.

Testing

Recent studies have demonstrated a linkage between low-voltage electrocardiogram (ECG) (LVE) (QRS complexes of <5 mm in the limb and <10 mm in the precordial leads) and Anasarca.