II. Definitions

  1. Heat Edema
    1. Acute edema related to heat exposure

III. Epidemiology

  1. Occurs in non-acclimitized patients (esp. elderly)

IV. Pathophysiology

  1. In warm environments, body shunts warm blood to periphery via peripheral vasodilation
  2. Also associated with salt or water retention from heat
  3. Increased peripheral fluid results in microvascular transudate
  4. Despite edema, patients are typically intravascularly volume depleted
  5. May be provoked by rapid transition from cold to hot environments

V. Symptoms

VI. Signs

  1. Weight gain up to 5 kg over several days
  2. Distribution
    1. Ankle edema (most common)
    2. Hand edema

VII. Differential Diagnosis

  1. See Edema

VIII. Labs

IX. Management

  1. Move to cooler environment
  2. Elevate extremities
  3. Consider Compression Stockings
  4. Do NOT administer Diuretics (not helpful and potentially harmful in a volume depleted patient)

X. Course

  1. Onset within 48 hours of arriving in warm climate
  2. Resolves with acclimatization diuresis in a few days

XI. References

  1. Salinas and Ruttan (2017) Crit Dec Emerg Med 31(9): 3-10
  2. Zink (2020) Crit Dec Emerg Med 34(3): 19-27

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