II. Definitions
- Heat Edema
- Acute edema related to heat exposure
III. Epidemiology
- Occurs in non-acclimitized patients (esp. elderly)
IV. Pathophysiology
- In warm environments, body shunts warm blood to periphery via peripheral vasodilation
- Also associated with salt or water retention from heat
- Increased peripheral fluid results in microvascular transudate
- Despite edema, patients are typically intravascularly volume depleted
- May be provoked by rapid transition from cold to hot environments
V. Symptoms
VI. Signs
- Weight gain up to 5 kg over several days
- Distribution
- Ankle edema (most common)
- Hand edema
VII. Differential Diagnosis
- See Edema
VIII. Labs
- Serum Sodium decreased (Hyponatremia)
IX. Management
- Move to cooler environment
- Elevate extremities
- Consider Compression Stockings
- Do NOT administer Diuretics (not helpful and potentially harmful in a volume depleted patient)
X. Course
- Onset within 48 hours of arriving in warm climate
- Resolves with acclimatization diuresis in a few days
XI. References
- Salinas and Ruttan (2017) Crit Dec Emerg Med 31(9): 3-10
- Zink (2020) Crit Dec Emerg Med 34(3): 19-27