Your doctor will obtain a detailed medical history and conduct a full exam. He or she will listen to your lungs through a stethoscope to detect the presence of fluid (an indication of pulmonary edema) and look at the veins in your neck.
Your doctor might order tests to help make a diagnosis. Results of blood and urine tests are useful for the diagnosis of certain types of fluid overload related to kidney or liver disease. Your doctor may order tests to detect abnormalities in your heart's electrical activity, size, shape and function during rest and exercise.
If you have fluid overload, your doctor will probably suggest that you reduce the amount of sodium (salt) in your diet. Doing so can be a very effective way of combating the buildup of excess fluid. Most Americans eat a diet containing lots of processed foods, which are very high in sodium.
Leg, ankle and foot edema can be improved if you elevate your legs above the level of your heart for 30 minutes three or four times each day. Compression or support stockings can also help edema.
Your doctor may prescribe oral medicines (diuretics or "water pills") to reduce the symptoms of the condition. Diuretics cause the kidneys to pass more water and sodium, reducing fluid volume throughout the body. Unfortunately, these medications often become less effective the longer one takes them, and eventually many people with fluid overload require hospitalization.
Typically, an in-hospital treatment for a serious case of edema includes intravenous (given with a needle into the bloodstream) administration of medications such as diuretic drugs, vasodilator drugs and inotropic drugs.
If intravenous drug therapy doesn't relieve the edema, patients may receive a procedure known as ultrafiltration, which uses a filtering device to remove excess fluid.
Follow the links below to learn more about fluid overload and edema.
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- Costanzo MR, Guglin ME, Saltzberg MT, et al. Ultrafiltration versus intravenous diuretics for patients hospitalized for acute decompensated heart failure. J Am Coll Cardiol. 2007; 49:675-683.
- Costanzo MR, Saltzberg M, O'Sullivan J. Early ultrafiltration in patients with decompensated heart failure and diuretic resistance. J Am Coll Cardiol. 2005;46:2047-2051.
- Elkayam U, Hatamizadeh P, Janmohamed M. The challenge of correcting volume overload in hospitalized patients with decompensated heart failure. J Am Coll Cardiol. 2007;49:684-686.