MULTIFACTORIAL ETIOLOGY OF LOWER LIMB EDEMA IN ELDERLY PATIENT WITH HEART FAILURE. CASE REPORT

Aging population and increasing life expectancy has led to an exponential increase in the incidence of heart failure. In the elderly patient with heart failure lower limb edema is most commonly considered in the context of decompensated heart disease, causes such as malnutrition, kidney and liver disease or secondary drug effects being rarer. We report two cases of edema of noncardiac origin. In the first case, kidney damage was identified, edema resulting from hypoproteinemia and proteinuria, and in the second case it had an iatrogenic cause, namely the adverse effect of dihydropyridine calcium channel blocker. In the latter case, investigations centered on the assessment of body composition revealed the tendency to dehydration vs. hyperhydration, which led to a different therapeutic approach compared to the general tendency to administer per primam a diuretic treatment. The elderly patient with comorbidities that associate heart failure and lower limb edema requires careful investigations of the possible alternative causes.